Recomendaciones de práctica clínica de la Sociedad Española Multidisciplinar de Dolor (SEMDOR) para el buen uso médico de los opioides de prescripción en el tratamiento del dolor crónico no oncológico

  1. Esperanza Regueras 1
  2. Luis M. Torres 2
  3. Ignacio Velázquez 3
  1. 1 Universidad de Navarra
    info

    Universidad de Navarra

    Pamplona, España

    ROR https://ror.org/02rxc7m23

  2. 2 Hospital Puerta del Mar
  3. 3 Asociación Andaluza del Dolor
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Zeitschrift:
MPJ Multidisciplinary Pain Journal

ISSN: 2697-2263

Datum der Publikation: 2022

Nummer: 1

Art: Artikel

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Andere Publikationen in: MPJ Multidisciplinary Pain Journal

Zusammenfassung

Opioid analgesics are essential and irreplaceable drugs in the treatment and control of pain. On the other hand, we must not forget that pain control is also an internationally recognized human right. However, the fear and rejection of the use of opioids as a result of the epidemic situation experienced in the United States has led to an undertreatment of patients, as Meyers and Quenzer state in their book on psychopharmacology, where they talk about how an unfounded fear of addiction has deprived many patients of receiving adequate pain relief. The treatment of pain is the responsibility of several health professionals, with Primary Care doctors prescribing these drugs the most, either by their own decision or by continuation of a prescription from the specialist. On the other hand, the incidence and prevalence of pain is expected to continue growing in the coming years mainly due to the greater survival of patients suffering from oncological and non-oncological pathologies. In this environment, it is essential to provide guidelines for the correct use of opioid drugs by prescribers and dispensers. To this end, SEMDOR present these recommendations on how to make good medical use of opioid drugs to treat chronic non-oncological pain (persistent or recurrent) lasting more than 3 months. These recommendations provide specific guide for addressing the selection of patients eligible for opioid treatment, as well as for initiation, follow-up, monitoring, or discontinuation of treatment. Additionally, recommendations are established on the responsibilities and resources that affect doctors, pharmacists and patients. Finally, we provide some points of improvement that should be implemented in relation to the management of opioid drugs at the level of health systems to enhance the systems for measuring prescriptions and adverse events, optimize dispensing with the use of new technologies, advance in multidisciplinary coordination and establish quick and simple means to communicate clinical recommendations such as the one presented here to all stakeholders. As a special warning, it should be noted that the intention of these document is not to contradict any other guide or protocol established at the level of scientific societies or institutions, but to serve as a guide and help in the day to day of clinical practice, incorporating the recommendations that we consider most appropriate to the clinical reality with the aim of guiding prescribing doctors and pharmacists towards the good medical use of opioid drugs.

Bibliographische Referenzen

  • O’Brien T, Christrup LL, Drewes AM, Fallon MT, Kress HG, McQuay HJ, Mikus G, Morlion BJ, Perez-Cajaraville J, Pogatzki-Zahn E, Varrassi G, Wells JC. European Pain Federation position paper on appropriate opioid use in chronic pain management. Eur J Pain. 2017;21(1):3-19. DOI: 10.1002/ejp.970.
  • Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain 2016;17(2):131-157.
  • Roehr B. Trump declares opioid public health emergency but no extra money. BMJ. 2017;359:j4998.
  • Gostin LO, Hodge JG Jr, Noe SA. Reframing the Opioid Epidemic as a National Emergency. JAMA. 2017;318(16):1539-40.
  • McCarthy M. US declares opioid epidemic a “national emergency”. BMJ. 2017;358:j3881.
  • Bonnie RJ, Kesselheim AS, Clark DJ. Both Urgency and Balance Needed in Addressing Opioid Epidemic: A Report From the National Academies of Sciences, Engineering and Medicine. JAMA. 2017;318(5):423-4.
  • Kirson NY, Scarpati LM, Enloe CJ, Dincer AP, Birnbaum HG, Mayne TJ. The Economic Burden of Opioid Abuse: Updated Findings. J Manag Care Spec Pharm. 2017;23(4):427-45.
  • Pollack HA. So Prescription Opioid Disorders are a $785 Billion Problem. Med Care. 2016;54(10):899-900.
  • Rose ME. Are prescription opioids driving the opioid crisis? Assumptions vs Facts. Pain Medicine. 2018;19(4):793-807.
  • Meyer JS, Quenzer LF. Psychopharmacology, drugs, the brain and behavior. International second edition. Oxford University Press, 2018.
  • Karmali RN, Bush C, Raman SR, Campbell CI, Skinner AC, Roberts AW. Long-term opioid therapy definitions and predictors: A systematic review. Pharmacoepidemiol Drug Saf. 2020;29(3):252-69.
  • Häuser W, Morlion B, Vowles KE, Bannister K, Buchser E, Casale R, et al. European* clinical practice recommendations on opioids for chronic noncancer pain - Part 1: Role of opioids in the management of chronic noncancer pain. Eur J Pain. 2021;25(5):949-68.
  • Krčevski Škvarč N, Morlion B, Vowles KE, Bannister K, Buchsner E, Casale R, et al. European clinical practice recommendations on opioids for chronic noncancer pain - Part 2: Special situations. Eur J Pain. 2021;25(5):969-85.
  • Regueras E, López J. Prescripciones de opioides en España entre 2019 y 2020: qué especialidades médicas lo están prescribiendo y en qué indicaciones. MPJ. 2021;1:5-12.
  • Gilson AM, Maurer MA, Ryan KM, Skemp-Brown M, Husain A, Cleary J. Ensuring patient access to essential medicines while minimising harmful use: A revised World Health Organization tool to improve national drug control policy. J Pain Palliat Care Pharmacother. 2011;25(3):246-51.
  • Portenoy RK, Foley KM. Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain. 1986;25(2):171-86.
  • Häuser W, Klose P, Welsch P, Petzke F, Nothacker M, Kopp I. Methodology of the development of the updated LONTS guidelines for long-term administration of opioids in noncancer pain]. Schmerz. 2015;29(1):8-34.
  • Friedmann N, Klutzaritz V, Webster L. Long-term safety of Remoxy® (extended-release oxycodone) in patients with moderate to severe chronic osteoarthritis or low back pain. Pain Med. 2011;12(5):755-60.
  • Blagden M, Hafer J, Duerr H, Hopp M, Bosse B. Long-term evaluation of combined prolonged-release oxycodone and naloxone in patients with moderate-to-severe chronic pain: pooled analysis of extension phases of two Phase III trials. Neurogastroenterol Motil. 2014;26(12):1792-801.
  • Dupoiron D, Stachowiak A, Loewenstein O, Ellery A, Kremers W, Bosse B, et al. Long-term efficacy and safety of oxycodone-naloxone prolonged-release formulation (up to 180/90 mg daily) - results of the open-label extension phase of a phase III multicenter, multiple-dose, randomized, controlled study. Eur J Pain. 2017;21(9):1485-94.
  • Wild JE, Grond S, Kuperwasser B, Gilbert J, McCann B, Lange B, et al. Long-term safety and tolerability of tapentadol extended release for the management of chronic low back pain or osteoarthritis pain. Pain Pract. 2010;10(5):416-27.
  • Buynak R, Rappaport SA, Rod K, Arsenault P, Heisig F, Rauschkolb C, et al. Long-term Safety and Efficacy of Tapentadol Extended Release Following up to 2 Years of Treatment in Patients With Moderate to Severe, Chronic Pain: Results of an Open-label Extension Trial. Clin Ther. 2015;37(11):2420-38.
  • Briggs EV, Battelli D, Gordon D, Kopf A, Ribeiro S, Puig MM, et al. Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study. BMJ Open. 2015;5(8):e006984.
  • Chou R, Ballantyne JC, Fanciullo GJ, Fine PG, Miaskowski C. Research gaps on use of opioids for chronic noncancer pain: findings from a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10(2):147-59.
  • Vadivelu N, Mitra S, Kai AM, Kodumudi G, Gritsenko K. Review of perioperative pain management of opioid-dependent patients. J Opioid Manag. 2016;12(4):289-301.
  • Quinlan J, Cox F, FRCNb. Acute pain management in patients with drug dependence syndrome. Pain Rep. 2017;2(4):e611.
  • Vadivelu N, Lumermann L, Zhu R, Kodumudi G, Elhassan AO, Kaye AD. Pain Control in the Presence of Drug Addiction. Curr Pain Headache Rep. 2016;20(5):35.
  • Jara C, Del Barco S, Grávalos C, Hoyos S, Hernández B, Muñoz M, et al. SEOM clinical guideline for treatment of cancer pain (2017). Clin Transl Oncol. 2018;20(1):97-107.
  • Grupo de trabajo de Opioides. Sociedad Española de Dolor. Decálogo en el manejo de opioides [Internet]. Sociedad Española del Dolor; 12 de marzo de 2018 [Accedido el 10 de abril de 2021]. Disponible en https://www.sedolor.es/download/decalogo-correcto-manejo-opioides/
  • Grupo de trabajo de Opioides. Sociedad Española de Dolor. Conclusiones de la jornada del Grupo de Opioides [Internet]. Sociedad Española del Dolor; 10 de marzo de 2018 [Accedido de 10 abril de 2021]. Disponible en: https://www.sedolor.es/download/conclusiones-la-jornada-del-grupo-opioides-madrid-10-marzo-2018/
  • Álvarez Mazariegos JA, Calvete Waldomar S, Fernández-Marcote Sánchez-Mayoral RM, Guardia Serecigni S, Henche Ruiz AI, Lligoña Garreta A, et al. Guía consenso sobre el buen uso de analgésicos opioides. Gestión de riesgos y beneficios [Internet]. Ministerio de Sanidad; junio de 2017 [Accedido el 10 de abril de 2021]. Disponible en: https://pnsd.sanidad.gob.es/profesionales/publicaciones/catalogo/bibliotecaDigital/publicaciones/pdf/2017_GUIA_Buen_uso_opioides_Socidrigalcohol.pdf
  • Prácticas seguras para el uso de opioides en pacientes con dolor crónico. Informe 2015. Documento de consenso sobre prácticas para el manejo seguro de opioides en pacientes con dolor crónico [Internet]. Ministerio de Sanidad, Servicios Sociales e Igualdad; 2015 [Accedido el 10 de abril de 2021]. Disponible en: https://www.mscbs.gob.es/gl/biblioPublic/publicaciones.do?metodo=detallePublicacion&publicacion=16593
  • Zenz M, Willweber-Strumpf A. Opiophobia and cancer pain in Europe. Lancet. 1993;341(8852):1075-6.
  • Campbell JN. Presidential address. Pain Forum. APS. 1996;1(5):85-8.
  • TJC The Joint Commission. Joint Commission. [Online].; 2018 [cited 2019 Febrero. Available from: https://www.jointcommission.org/facts_about_joint_commission_accreditation_standards_for_health_care_organizations_pain_assessment_and_management/
  • World Health Organization. Cancer pain relief [Internet]. Organización Mundial de la Salud; 1986 [Accedido en enero de 2019]. Disponible en: http://www.who.int/iris/handle/10665/43944.
Fuente de los datos: Dialnet