PMID- 26568890
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20151116
LR  - 20200930
IS  - 2090-1542 (Print)
IS  - 2090-1550 (Electronic)
IS  - 2090-1542 (Linking)
VI  - 2015
DP  - 2015
TI  - Physicians Experience with and Expectations of the Safety and Tolerability of 
      WHO-Step III Opioids for Chronic (Low) Back Pain: Post Hoc Analysis of Data from 
      a German Cross-Sectional Physician Survey.
PG  - 745048
LID - 10.1155/2015/745048 [doi]
LID - 745048
AB  - Objective. To describe physicians' daily life experience with WHO-step III 
      opioids in the treatment of chronic (low) back pain (CLBP). Methods. Post hoc 
      analysis of data from a cross-sectional online survey with 4.283 Germany 
      physicians. Results. With a reported median use in 17% of affected patients, 
      WHO-step III opioids play a minor role in treatment of CLBP in daily practice 
      associated with a broad spectrum of positive and negative effects. If prescribed, 
      potent opioids were reported to show clinically relevant effects (such as >/=50% 
      pain relief) in approximately 3 of 4 patients (median 72%). Analgesic effects 
      reported are frequently related with adverse events (AEs). Only 20% of patients 
      were reported to remain free of any AE. Most frequently reported AE was 
      constipation (50%), also graded highest for AE-related daily life restrictions 
      (median 46%). Specific AE countermeasures were reported to be necessary in 
      approximately half of patients (median 45%); nevertheless AE-related premature 
      discontinuation rates reported were high (median 22%). Fentanyl/morphine were the 
      most/least prevalently prescribed potent opioids mentioned (median 20 versus 8%). 
      Conclusion. Overall, use of WHO-step III opioids for CLBP is low. AEs, especially 
      constipation, are commonly reported and interfere significantly with analgesic 
      effects in daily practice. Nevertheless, beneficial effects outweigh related AEs 
      in most patients with CLBP.
FAU - Ueberall, Michael A
AU  - Ueberall MA
AD  - Institute for Neurological Sciences, Nordostpark 51, 90411 Nuernberg, Germany.
FAU - Eberhardt, Alice
AU  - Eberhardt A
AD  - Mundipharma GmbH, Mundipharmastrasse 2, 65549 Limburg, Germany.
FAU - Mueller-Schwefe, Gerhard H H
AU  - Mueller-Schwefe GH
AD  - Interdisciplinary Center for Pain and Palliative Care Medicine, Schillerplatz 
      8/1, 73033 Goeppingen, Germany.
LA  - eng
PT  - Journal Article
DEP - 20151018
PL  - United States
TA  - Pain Res Treat
JT  - Pain research and treatment
JID - 101566863
PMC - PMC4629054
EDAT- 2015/11/17 06:00
MHDA- 2015/11/17 06:01
PMCR- 2015/10/18
CRDT- 2015/11/17 06:00
PHST- 2015/07/29 00:00 [received]
PHST- 2015/09/21 00:00 [accepted]
PHST- 2015/11/17 06:00 [entrez]
PHST- 2015/11/17 06:00 [pubmed]
PHST- 2015/11/17 06:01 [medline]
PHST- 2015/10/18 00:00 [pmc-release]
AID - 10.1155/2015/745048 [doi]
PST - ppublish
SO  - Pain Res Treat. 2015;2015:745048. doi: 10.1155/2015/745048. Epub 2015 Oct 18.