Photo Credit: Andranik Hakobyan

The following is a summary of “Does opioid therapy enhance quality of life in patients suffering from chronic non-malignant pain? A systematic review and meta-analysis,” published in the November 2023 issue of Pain by Kraft et al.

Chronic pain negatively impacts health-related quality of life (HRQL), and the effectiveness of opioid therapy in chronic non-malignant pain remains uncertain.

Researchers performed a retrospective study to evaluate the role of opioid therapy in enhancing HRQL for individuals with chronic non-malignant pain, aiming to inform clinical practice.

In June 2020, they searched PubMed, EMBASE, and CENTRAL for double-blind, randomized trials (RCTs) that compared opioid therapy to placebo and evaluated an HRQL questionnaire. This involved qualitative vote counting and a meta-analysis of the Short Form Health Survey (SF-36), EQ-5D questionnaire, and the Brief Pain Inventory (BPI) pain interference scale.

The results showed 35 RCTs, with the majority indicating a positive impact of opioids on EQ-5D, BPI, and the Physical Component Score (PCS) of SF-36 compared to placebo. The meta-analysis for PCS revealed a mean difference of 1.82 [CI: 1.32, 2.32], and for EQ-5D, an advantage of 0.06 [0.00, 0.12]. In the qualitative analysis of the Mental Component Score (MCS) of SF-36, no discernible positive or negative trend was observed. No notable differences were noted in the MCS (MD: 0.65 [-0.43, 1.73]). The opioid group showed a slightly elevated premature dropout rate (RD: 0.04 [0.00, 0.07], P=.07), categorizing the overall evidence as low to medium.

They concluded that opioid therapy had a small and insignificant effect on physical HRQL but no impact on mental HRQL.

Source: journals.sagepub.com/doi/10.1177/20494637231216352