Open AccessUtility Assessments of Opioid Treatment for Chronic Pain
Author(s) -
Schmier Jordana K.,
Palmer Cynthia S.,
Flood Emuella M.,
Gourlay Geoffrey
Publication year - 2002
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1046/j.1526-4637.2002.02045.x
Subject(s) - medicine , quality of life (healthcare) , chronic pain , tolerability , physical therapy , vomiting , brief pain inventory , depression (economics) , opioid , mood , pain catastrophizing , cancer pain , cancer , psychiatry , adverse effect , receptor , nursing , economics , macroeconomics
Objective. The primary study objective was to assess preferences for pain treatment outcomes among patients with cancer and noncancer chronic pain. A secondary objective was to assess their quality of life. Methods. Patients with cancer or noncancer chronic pain completed an interview using a computer to estimate utilities, or preference ratings, for health states related to pain treatment. The interview was devised using conjoint analysis methodology. Health states were characterized by four attributes (effectiveness of pain control, side effects, side effect severity, and opioid route of administration) and their levels, and each was assumed to last for a 14‐day period. Participants also completed health‐related quality of life and demographic questionnaires. Results. Mean preference ratings for participants with noncancer chronic pain (N = 96) ranged from a high of 0.87 (well‐controlled pain with no side effects) to a low of 0.18 (poorly controlled pain with severe mood changes/alterations, severe respiratory depression, or severe vomiting). Mean preference ratings for participants with cancer pain (N = 25) were similar and ranged from a high of 0.89 (well‐controlled pain with no side effects) to a low of 0.19 (poorly controlled pain with severe respiratory depression or severe vomiting). Results confirmed previous findings that chronic pain has a severe, multidimensional impact on patients, and that the quality of life of persons with chronic pain is among the lowest observed for any medical condition. Conclusions. This study provides a valuable assessment, from the patient's perspective, of the balance between treatment tolerability and manifestation of disease symptoms. Heightened awareness of patients' preferences for treatment outcomes may lead to improved selection of treatments, better adherence, and ultimate treatment success.