Chronic Noncancer PainNCT03161795
Addressing the Risks of Long-Term Opioid Therapy in Chronic Noncancer Pain
An observational study of Chronic Noncancer Pain and Opioid-Related Disorders, run by Seoul National University at 1 site in South Korea.
Trial summary
PURPOSE: Assess the risks of long-term opioid therapy, especially opioid use disorders such as opioid-related chemical coping in chronic noncancer pain patients. Pain, particularly chronic pain, is a major threat to the quality of life worldwide and will become more so as the average age increases. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chronic Noncancer Pain, Opioid-Related Disorders
- How many people
- 258 participants
- Where
- 1 siteSouth Korea
- Study dates
- 25 Apr 2017to 12 Mar 2018
- How long will I take part?
- 3 Months
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study was open-labeled, national, multicenter, observational, cohort study conducted at 8 Tertiary hospitals located in South Korea. The study population were patients with chronic noncancer pain receiving long-term opioid therapy and attending the outpatient pain clinic of any of the participant hospitals.
Inclusion criteria were as follows: 1) patients at age equal or greater than 18 years; 2) patients with a diagnosis of chronic pain defined by the American Chronic Pain Association (ACPA) as an ongoing or recurrent pain, lasting beyond the usual course of acute illness or injury or more than 3 months, and which adversely affected the individuals' well-being; 3) patients with CNCP with opioid medication for treatment and/or control of chronic pain; 4) patients who were receiving long-term opioid therapy defined as the use of opioids on most days for a period of time greater than 3 months; and 5) patients who complete the screening tools and questionnaires evaluated in the study.
Exclusion criteria were as follows: 1) patients with diagnosis and/or ongoing cancer treatment or palliative or receiving end-of-life care; 2) patients younger than 18 years of age; 3) patients without current opioid therapy for the treatment and/or control of chronic pain; 4) patients with chronic pain that received opioid therapy intermittently or for less than 3 months; 5) serious systemic diseases (Myasthenia Gravis, decreased lung function, severe liver problems, severe renal impairment, shock, hypo- or hyperpotassemia) or psychiatric disorders (schizophrenia and acute anxiety) that compromise the patients safety or the completion of the survey; or 6) patients with intellectual impairment to answer the tools and questionnaires evaluated.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Addressing the Risks of Long-Term Opioid Therapy in Chronic Noncancer Pain: A National, Multicenter, and Observational Cross-sectional Study in South Korea
PURPOSE: Assess the risks of long-term opioid therapy, especially opioid use disorders such as opioid-related chemical coping in chronic noncancer pain patients.
Pain, particularly chronic pain, is a major threat to the quality of life worldwide and will become more so as the average age increases. Currently, over 30% of the world's population is known to have chronic pain. Among a plethora of treatment options, opioid agonists is one of treatment options for moderate to severe chronic pain. Although its consumption has increased during the last two decades,3 it remains below the requirements in most regions, including the Asian countries. In South Korea (S. Korea), opioid consumption for medical purposes in 2015 was still below average, ranked 43rd globally and 30th among 35 Organisation for Economic Co-operation and Development (OECD) countries (55 mg/capita in S. Korea vs. 258 mg/capita in an average of OECD countries). Conversely, in countries with high opioid consumption such as the United States of America (US), drug overdose deaths (the majority involving an opioid) have nearly quadrupled since 1999.
Read more
The up to date literature on opioid use disorder (OUD) is characterized by great variability of definitions, measurements, demographics, and opioid use duration. Moreover, an overwhelming majority of the studies took place in the US, the country with the highest opioid consumption and a current opioid crisis. Additionally, stringent restrictions and regulations to prevent OUD may result in inadequate pain control and insufficient opioid therapy, especially in countries with relatively low-moderate opioid consumption rates. Therefore, in compliance with growth in medical opioid use and the lack of studies in countries with low-moderate opioid consumption, it is necessary to determine the occurrence of OUD in chronic noncancer pain (CNCP) patients receiving long-term opioid therapy (LtOT).
In this study, we will perform a national, multicenter, observational cross-sectional study to address the current status of opioid treatment for CNCP in S. Korea, a country with moderate opioid consumption. The ultimate aims of this study are to estimate the frequency of OUD such as OrCC, to evaluate the functional and psychiatric characteristics of patients, and to determine the risk factors associated with OUD in CNCP patients receiving LtOT.
Read the detailed description
Chronic pain is a devastating disease often treated inadequately. More than 30 percent of the world population suffers from chronic pain. Among a plethora of treatment options, opioid agonists is one of treatment options for moderate to severe chronic pain. Although its consumption has increased during the last two decades, it remains below the requirements in most regions, including the Asian countries. In South Korea (S. Korea), opioid consumption for medical purposes in 2015 was still below average, ranked 43rd globally and 30th among 35 Organisation for Economic Co-operation and Development (OECD) countries (55 mg/capita in S. Korea vs. 258 mg/capita in an average of OECD countries). However, it is remarkable that the opioid consumption in S. Korea has increased 5-6 times since 2005 (10 mg/capita), ranking 3rd among Asian countries, preceded only by Vietnam (62 mg/capita) and Malaysia (60 mg/capita).
One of the reluctant factors to prescribe opioids is induced reward responses, resulting in opioid use disorders (OUD). Particularly, in chronic noncancer pain (CNCP), concerns regarding drug dependence in the long-term opioid therapy (LtOT) remain its use controversial. The spectrum of OUD in CNCP patients is wide and varies from misuse without a compliant intake to addiction with a severe aberrant consumption. Between the extremes, opioid-related chemical coping (OrCC) may lie in a middle ground group, characterized by an inappropriate use of opioids to cope with emotional distress. Although, OrCC is a terminology first used in cancer patients, a recent study found a high correlation between the reports of aberrant medication-taking behavior by experienced providers and chemical coping by CNCP patients.
OrCC should be distinguished from psychologic addiction, a neurobiological disease that corresponds with the most severe substance-use disorder referring to neuroplasticity and a substantial loss of self-control. All addicts are eventually chemical copers, but not all chemical copers are addicts. A better understanding of this intermediate status may be crucial to prompt to identify the risk of severe OUD and re-direct their management to avoid unnecessary opioid toxicity and achieve adequate pain control. However, studies to measure OrCC are scarce and the evidence of OUD in CNCP in countries with relatively low opioid consumption is practically unavailable.
The up to date literature on OUD is characterized by great variability of definitions, measurements, demographics, and opioid use duration. Moreover, an overwhelming majority of the studies took place in the United Stated of America (US), the country with the highest opioid consumption and a current opioid crisis. Despite their over-consumption, however, studies in those countries showed that CNCP is still undertreated and even suggested that OUD might not be related to the prescription to pain patients. From a different angle, stringent restrictions and regulations to prevent OUD may result in inadequate pain control and insufficient opioid therapy, especially in countries with relatively low- moderate opioid consumption rates. Therefore, to strike a balance when treating pain with opioids, it is indispensable to determine the characteristics of OUD in CNCP patients with LtOT in countries with low-moderate opioid consumption. Moreover, in S. Korea there are not available statistics regarding the OUD occurrence in CNCP patients and national guidelines on LtOT in CNCP have not been developed.
In this study, we will perform a national, multicenter, observational cross-sectional study to address the current status of opioid treatment and OUD for CNCP in S. Korea, a country with moderate opioid consumption since 2010. The availability of up-to-date data on OUD is necessary for the development of national guidelines to prevent severe harms of opioids, enhance patients and physicians' satisfaction, potentiate opioid's benefits, and guaranty adequate pain control in the CNCP population. The ultimate aims of this study are to estimate the frequency of OUD (such as OrCC), to evaluate the patient's functional and psychiatric characteristics, and to determine the risk factors associated with OUD in CNCP patients receiving LtOT. The results of this study will help to seize the occurrence of OUD in countries with low-moderate opioid consumption thus it will approach the real risk effect of LtOT in CNCP.
- Conditions
- Chronic Noncancer Pain, Opioid-Related Disorders
- Keywords
- Chemical coping, Long-term opioid therapy, Risk factors, Predictive tools, Frequency
- Medical subject headings
- Opioid-Related Disorders
What is being measured
The primary outcome is the main question the study is designed to answer.
Frequency of opioid-related chemical coping
Prevalence of chemical coping with opioids in the study population by the pain specialists participating in the study through a questionnaire that contained the per-protocol definition of chemical coping and seven different aberrant behaviors related to chemical coping proposed by a panel of experts. One or more affirmative answers were considered as "positive"
Measured: The assessment took place during a routine outpatient clinic 1 day visit. The presence of chemical coping was evaluated by pain specialist through the questionnaire immediately after the routine visit of each patient.
Secondary outcomes (3)
Sociodemographic characteristics of chronic noncancer pain patients using long-term opioid therapy
Patients' demographic data (sex, age, ethnicity, body mass index, marital status, education, and employment status), pain characteristics [duration, intensity using an 11-pointed numerical rating pain scale (NRS) score ranged from 0 (no pain) to 10 (pain as bad as you can imagine), etiology, location, and type of pain such as nociceptive, neuropathic, functional pain syndrome (fibromyalgia, temporomandibular disorder, etc.), and mixed, co-morbid psychiatric disease, substance abuse history, secondary morbid gain, ongoing litigation, history of taken prescription drugs with alcohol, and suicidal ideation] were collected.
Measured: The data was collected from the start of the study up to 3 months after finishing recruitment. The NRS was assessed in each patient during the routine visit with a pain specialist.
Characteristic of opioid's use in chronic noncancer pain in South Korea
Opioid information including duration of administration, opioid types (long-acting vs. short-acting), route of administration (oral, transdermal, mucosal, or intravenous), Morphine Equivalent Daily Dosage (MEDD, mg/day), the initial prescriber, number of visits per year to an opioid prescriber, and history of Emergency room (ER) visits seeking for opioids, as well as concomitant use of benzodiazepines and other medication such as antidepressants, anticonvulsants, and/or topical agents were obtained.
Measured: The data was collected from the start of the study up to 3 months after finishing recruitment.
Risk factors associated to long-term opioid therapy and opioid-related chemical coping
The assessment was conducted through a survey in the outpatient setting of each pain clinic. The survey contained a number of questionnaires including 1) the Cut, Annoyed, Guilty, Eye-opener - Adapted to Include Drugs (CAGE-AID); 2) the Brief Pain Inventory-Short Form (BPI-SF); 3) Pain Catastrophizing Scale; 4) Hospital Anxiety and Depression Scale (HADS); 5) Insomnia Severity Index (ISI); 6) Korean Instrumental Activities of Daily Living Scale (K-IADL); 7) Korean-Connor-Davidson Resilience Scale (K-CD-RISC); and 8) Patient Global Impression of Change Scale.
Measured: The patients answered to the questionnaires and tools before a routine 1 day visit. Each patient finished the evaluation on the same day of the visit. The record of answers will take place from the start to the finish of recruitment.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 May 2017
- Study start25 Apr 2017
- Primary completion19 Jan 2018
- Study completion12 Mar 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (21)Papers the sponsor has linked to this study.
- Other trials for Chronic Noncancer PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Prospective
- Enrolment
- 258 participants (actual)
- Target duration
- 3 Months
Sponsor and investigators
- Lead sponsor
- Seoul National University
- Sponsor type
- University, hospital or other
- Collaborators
- Seoul National University Bundang Hospital, Korea University Guro Hospital, Ewha Womans University, Ajou University School of Medicine, Konkuk University Hospital, Chung-Ang University Hospital, Seoul St. Mary's Hospital
- Responsible party
- Principal investigator, Jeeyoun Moon, Seoul National University
- Investigators
- Jee Y Moon, MD, PhD, Study director, Seoul National University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03161795
- Sponsor's protocol ID
- 1702-020-829
- Status last verified
- Nov 2022
- First submitted
- 16 May 2017
- Last updated
- 8 Nov 2022
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Mil Med. 2016 May;181(5):397-9. doi: 10.7205/MILMED-D-16-00012. No abstract available.
PubMed 27136641Kaplan JA, Richards-Waugh LL, Bailey KM, Kraner JC. Epidemic: fatal pharmaceutical abuse in West Virginia 1991-2008. W V Med J. 2010;106(4 Spec No):88-90. No abstract available.
PubMed 21932761Krnic D, Anic-Matic A, Dosenovic S, Draganic P, Zezelic S, Puljak L. National consumption of opioid and nonopioid analgesics in Croatia: 2007-2013. Ther Clin Risk Manag. 2015 Aug 28;11:1305-14. doi: 10.2147/TCRM.S86226. eCollection 2015.
PubMed 26357478Seya MJ, Gelders SF, Achara OU, Milani B, Scholten WK. A first comparison between the consumption of and the need for opioid analgesics at country, regional, and global levels. J Pain Palliat Care Pharmacother. 2011;25(1):6-18. doi: 10.3109/15360288.2010.536307.
PubMed 21426212Duthey B, Scholten W. Adequacy of opioid analgesic consumption at country, global, and regional levels in 2010, its relationship with development level, and changes compared with 2006. J Pain Symptom Manage. 2014 Feb;47(2):283-97. doi: 10.1016/j.jpainsymman.2013.03.015. Epub 2013 Jul 17.
PubMed 23870413Chung SS, Park CK, Cho KJ, Choi KH, Kim JH, Kim SB, Kuh SU, Lee JC, Lee JH, Lee KY, Lee SH, Moon SH, Park SY, Shim JH, Son BC, Yoon MH, Park HJ. A Nationwide Retrospective Study of Opioid Management Patterns in 2,468 Patients with Spinal Pain in Korea. Asian Spine J. 2016 Dec;10(6):1122-1131. doi: 10.4184/asj.2016.10.6.1122. Epub 2016 Dec 8.
PubMed 27994790Centers For Disease Control And Prevention Public Health Service U S Department Of Health And Human Services. Guideline for Prescribing Opioids for Chronic Pain. J Pain Palliat Care Pharmacother. 2016 Jun;30(2):138-40. doi: 10.3109/15360288.2016.1173761.
PubMed 27301691Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, Cohen R, Dow L. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009 Aug;20(8):1420-33. doi: 10.1093/annonc/mdp001. Epub 2009 Feb 24.
PubMed 19244085O'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 Jan;21(1):3-19. doi: 10.1002/ejp.970.
PubMed 27991730Kwon JH, Hui D, Bruera E. A Pilot Study To Define Chemical Coping in Cancer Patients Using the Delphi Method. J Palliat Med. 2015 Aug;18(8):703-6. doi: 10.1089/jpm.2014.0446. Epub 2015 Apr 29.
PubMed 25922879Del Fabbro E. Assessment and management of chemical coping in patients with cancer. J Clin Oncol. 2014 Jun 1;32(16):1734-8. doi: 10.1200/JCO.2013.52.5170. Epub 2014 May 5.
PubMed 24799476Kwon JH, Tanco K, Park JC, Wong A, Seo L, Liu D, Chisholm G, Williams J, Hui D, Bruera E. Frequency, Predictors, and Medical Record Documentation of Chemical Coping Among Advanced Cancer Patients. Oncologist. 2015 Jun;20(6):692-7. doi: 10.1634/theoncologist.2015-0012. Epub 2015 May 1.
PubMed 25933929Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016 Dec 30;65(50-51):1445-1452. doi: 10.15585/mmwr.mm655051e1.
PubMed 28033313Le Merrer J, Becker JA, Befort K, Kieffer BL. Reward processing by the opioid system in the brain. Physiol Rev. 2009 Oct;89(4):1379-412. doi: 10.1152/physrev.00005.2009.
PubMed 19789384Kirsh KL, Jass C, Bennett DS, Hagen JE, Passik SD. Initial development of a survey tool to detect issues of chemical coping in chronic pain patients. Palliat Support Care. 2007 Sep;5(3):219-26. doi: 10.1017/s1478951507000387.
PubMed 17969825
Study at a glance
From the registry record, last updated by the sponsor on 8 Nov 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Addressing the Risks of Long-Term Opioid Therapy in Chronic Noncancer Pain: A National, Multicenter, and Observational Cross-sectional Study in South Korea
- ClinicalTrials.gov ID
- NCT03161795
- Acronym / sponsor ID
- 1702-020-829
- Conditions
- Chronic Noncancer Pain, Opioid-Related Disorders
- Keywords
- Chemical coping, Long-term opioid therapy, Risk factors, Predictive tools, Frequency
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 258 participants (actual)
- Lead sponsor
- Seoul National UniversityUniversity, hospital or other
- Collaborators
- Seoul National University Bundang Hospital, Korea University Guro Hospital, Ewha Womans University, Ajou University School of Medicine, Konkuk University Hospital, Chung-Ang University Hospital, Seoul St. Mary's Hospital
- Study start
- 25 Apr 2017 (actual)
- Primary completion
- 19 Jan 2018 (actual)
- Study completion
- 12 Mar 2018 (actual)
- First posted
- 22 May 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
PURPOSE: Assess the risks of long-term opioid therapy, especially opioid use disorders such as opioid-related chemical coping in chronic noncancer pain patients.
Pain, particularly chronic pain, is a major threat to the quality of life worldwide and will become more so as the average age increases. Currently, over 30% of the world's population is known to have chronic pain. Among a plethora of treatment options, opioid agonists is one of treatment options for moderate to severe chronic pain. Although its consumption has increased during the last two decades,3 it remains below the requirements in most regions, including the Asian countries. In South Korea (S. Korea), opioid consumption for medical purposes in 2015 was still below average, ranked 43rd globally and 30th among 35 Organisation for Economic Co-operation and Development (OECD) countries (55 mg/capita in S. Korea vs. 258 mg/capita in an average of OECD countries). Conversely, in countries with high opioid consumption such as the United States of America (US), drug overdose deaths (the majority involving an opioid) have nearly quadrupled since 1999.
The up to date literature on opioid use disorder (OUD) is characterized by great variability of definitions, measurements, demographics, and opioid use duration. Moreover, an overwhelming majority of the studies took place in the US, the country with the highest opioid consumption and a current opioid crisis. Additionally, stringent restrictions and regulations to prevent OUD may result in inadequate pain control and insufficient opioid therapy, especially in countries with relatively low-moderate opioid consumption rates. Therefore, in compliance with growth in medical opioid use and the lack of studies in countries with low-moderate opioid consumption, it is necessary to determine the occurrence of OUD in chronic noncancer pain (CNCP) patients receiving long-term opioid therapy (LtOT).
In this study, we will perform a national, multicenter, observational cross-sectional study to address the current status of opioid treatment for CNCP in S. Korea, a country with moderate opioid consumption. The ultimate aims of this study are to estimate the frequency of OUD such as OrCC, to evaluate the functional and psychiatric characteristics of patients, and to determine the risk factors associated with OUD in CNCP patients receiving LtOT.
Detailed description
Chronic pain is a devastating disease often treated inadequately. More than 30 percent of the world population suffers from chronic pain. Among a plethora of treatment options, opioid agonists is one of treatment options for moderate to severe chronic pain. Although its consumption has increased during the last two decades, it remains below the requirements in most regions, including the Asian countries. In South Korea (S. Korea), opioid consumption for medical purposes in 2015 was still below average, ranked 43rd globally and 30th among 35 Organisation for Economic Co-operation and Development (OECD) countries (55 mg/capita in S. Korea vs. 258 mg/capita in an average of OECD countries). However, it is remarkable that the opioid consumption in S. Korea has increased 5-6 times since 2005 (10 mg/capita), ranking 3rd among Asian countries, preceded only by Vietnam (62 mg/capita) and Malaysia (60 mg/capita).
One of the reluctant factors to prescribe opioids is induced reward responses, resulting in opioid use disorders (OUD). Particularly, in chronic noncancer pain (CNCP), concerns regarding drug dependence in the long-term opioid therapy (LtOT) remain its use controversial. The spectrum of OUD in CNCP patients is wide and varies from misuse without a compliant intake to addiction with a severe aberrant consumption. Between the extremes, opioid-related chemical coping (OrCC) may lie in a middle ground group, characterized by an inappropriate use of opioids to cope with emotional distress. Although, OrCC is a terminology first used in cancer patients, a recent study found a high correlation between the reports of aberrant medication-taking behavior by experienced providers and chemical coping by CNCP patients.
OrCC should be distinguished from psychologic addiction, a neurobiological disease that corresponds with the most severe substance-use disorder referring to neuroplasticity and a substantial loss of self-control. All addicts are eventually chemical copers, but not all chemical copers are addicts. A better understanding of this intermediate status may be crucial to prompt to identify the risk of severe OUD and re-direct their management to avoid unnecessary opioid toxicity and achieve adequate pain control. However, studies to measure OrCC are scarce and the evidence of OUD in CNCP in countries with relatively low opioid consumption is practically unavailable.
The up to date literature on OUD is characterized by great variability of definitions, measurements, demographics, and opioid use duration. Moreover, an overwhelming majority of the studies took place in the United Stated of America (US), the country with the highest opioid consumption and a current opioid crisis. Despite their over-consumption, however, studies in those countries showed that CNCP is still undertreated and even suggested that OUD might not be related to the prescription to pain patients. From a different angle, stringent restrictions and regulations to prevent OUD may result in inadequate pain control and insufficient opioid therapy, especially in countries with relatively low- moderate opioid consumption rates. Therefore, to strike a balance when treating pain with opioids, it is indispensable to determine the characteristics of OUD in CNCP patients with LtOT in countries with low-moderate opioid consumption. Moreover, in S. Korea there are not available statistics regarding the OUD occurrence in CNCP patients and national guidelines on LtOT in CNCP have not been developed.
In this study, we will perform a national, multicenter, observational cross-sectional study to address the current status of opioid treatment and OUD for CNCP in S. Korea, a country with moderate opioid consumption since 2010. The availability of up-to-date data on OUD is necessary for the development of national guidelines to prevent severe harms of opioids, enhance patients and physicians' satisfaction, potentiate opioid's benefits, and guaranty adequate pain control in the CNCP population. The ultimate aims of this study are to estimate the frequency of OUD (such as OrCC), to evaluate the patient's functional and psychiatric characteristics, and to determine the risk factors associated with OUD in CNCP patients receiving LtOT. The results of this study will help to seize the occurrence of OUD in countries with low-moderate opioid consumption thus it will approach the real risk effect of LtOT in CNCP.
Study design
- Observational model
- Other
- Time perspective
- Prospective
- Target follow-up
- 3 Months
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study was open-labeled, national, multicenter, observational, cohort study conducted at 8 Tertiary hospitals located in South Korea. The study population were patients with chronic noncancer pain receiving long-term opioid therapy and attending the outpatient pain clinic of any of the participant hospitals.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Frequency of opioid-related chemical coping
Time frame: The assessment took place during a routine outpatient clinic 1 day visit. The presence of chemical coping was evaluated by pain specialist through the questionnaire immediately after the routine visit of each patient.
Prevalence of chemical coping with opioids in the study population by the pain specialists participating in the study through a questionnaire that contained the per-protocol definition of chemical coping and seven different aberrant behaviors related to chemical coping proposed by a panel of experts. One or more affirmative answers were considered as "positive"
3 secondary outcomes
Sociodemographic characteristics of chronic noncancer pain patients using long-term opioid therapy
Time frame: The data was collected from the start of the study up to 3 months after finishing recruitment. The NRS was assessed in each patient during the routine visit with a pain specialist.
Characteristic of opioid's use in chronic noncancer pain in South Korea
Time frame: The data was collected from the start of the study up to 3 months after finishing recruitment.
Risk factors associated to long-term opioid therapy and opioid-related chemical coping
Time frame: The patients answered to the questionnaires and tools before a routine 1 day visit. Each patient finished the evaluation on the same day of the visit. The record of answers will take place from the start to the finish of recruitment.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Nov 2022.
- Background: PubMed 27136641Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Mil Med. 2016 May;181(5):397-9. doi: 10.7205/MILMED-D-16-00012. No abstract available.
- Background: PubMed 21932761Kaplan JA, Richards-Waugh LL, Bailey KM, Kraner JC. Epidemic: fatal pharmaceutical abuse in West Virginia 1991-2008. W V Med J. 2010;106(4 Spec No):88-90. No abstract available.
- Background: PubMed 26357478Krnic D, Anic-Matic A, Dosenovic S, Draganic P, Zezelic S, Puljak L. National consumption of opioid and nonopioid analgesics in Croatia: 2007-2013. Ther Clin Risk Manag. 2015 Aug 28;11:1305-14. doi: 10.2147/TCRM.S86226. eCollection 2015.
- Background: PubMed 21426212Seya MJ, Gelders SF, Achara OU, Milani B, Scholten WK. A first comparison between the consumption of and the need for opioid analgesics at country, regional, and global levels. J Pain Palliat Care Pharmacother. 2011;25(1):6-18. doi: 10.3109/15360288.2010.536307.
- Background: PubMed 23870413Duthey B, Scholten W. Adequacy of opioid analgesic consumption at country, global, and regional levels in 2010, its relationship with development level, and changes compared with 2006. J Pain Symptom Manage. 2014 Feb;47(2):283-97. doi: 10.1016/j.jpainsymman.2013.03.015. Epub 2013 Jul 17.
- Background: PubMed 27994790Chung SS, Park CK, Cho KJ, Choi KH, Kim JH, Kim SB, Kuh SU, Lee JC, Lee JH, Lee KY, Lee SH, Moon SH, Park SY, Shim JH, Son BC, Yoon MH, Park HJ. A Nationwide Retrospective Study of Opioid Management Patterns in 2,468 Patients with Spinal Pain in Korea. Asian Spine J. 2016 Dec;10(6):1122-1131. doi: 10.4184/asj.2016.10.6.1122. Epub 2016 Dec 8.
- Background: PubMed 27301691Centers For Disease Control And Prevention Public Health Service U S Department Of Health And Human Services. Guideline for Prescribing Opioids for Chronic Pain. J Pain Palliat Care Pharmacother. 2016 Jun;30(2):138-40. doi: 10.3109/15360288.2016.1173761.
- Background: PubMed 19244085Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, Cohen R, Dow L. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009 Aug;20(8):1420-33. doi: 10.1093/annonc/mdp001. Epub 2009 Feb 24.
- Background: PubMed 27991730O'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 Jan;21(1):3-19. doi: 10.1002/ejp.970.
- Background: PubMed 25922879Kwon JH, Hui D, Bruera E. A Pilot Study To Define Chemical Coping in Cancer Patients Using the Delphi Method. J Palliat Med. 2015 Aug;18(8):703-6. doi: 10.1089/jpm.2014.0446. Epub 2015 Apr 29.
- Background: PubMed 24799476Del Fabbro E. Assessment and management of chemical coping in patients with cancer. J Clin Oncol. 2014 Jun 1;32(16):1734-8. doi: 10.1200/JCO.2013.52.5170. Epub 2014 May 5.
- Background: PubMed 25933929Kwon JH, Tanco K, Park JC, Wong A, Seo L, Liu D, Chisholm G, Williams J, Hui D, Bruera E. Frequency, Predictors, and Medical Record Documentation of Chemical Coping Among Advanced Cancer Patients. Oncologist. 2015 Jun;20(6):692-7. doi: 10.1634/theoncologist.2015-0012. Epub 2015 May 1.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jee Y Moon, MD, PhD study director
Seoul National University Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Chronic Noncancer Pain and Opioid-Related Disorders, run by Seoul National University at 1 site in South Korea.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in South Korea. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Frequency of opioid-related chemical coping (time frame: The assessment took place during a routine outpatient clinic 1 day visit. The presence of chemical coping was evaluated by pain specialist through the questionnaire immediately after the routine visit of each patient.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03161795, which also lists 21 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Nov 2022.