Delphi study to explore a new diagnosis for "ineffective" long-term opioid therapy for chronic pain.

Autor:	Edmond SN; Pain Research Informatics Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, United States.; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States., Snow JL; Pain Research Informatics Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, United States., Pomeranz J; Department of Occupational Therapy, University of Florida, Gainesville, FL, United States., Van Cleve R; Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, United States.; Stanford University, Stanford, CA, United States., Black AC; Pain Research Informatics Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, United States.; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States., Compton P; Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA, United States., Becker WC; Pain Research Informatics Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, United States.; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
Jazyk:	angličtina
Zdroj:	Pain [Pain] 2023 Apr 01; Vol. 164 (4), pp. 870-876. Date of Electronic Publication: 2022 Sep 15.
DOI:	10.1097/j.pain.0000000000002783
Abstrakt:	Abstract: A challenge in clinical, research, and policy spheres is determining whether and how to apply the Diagnostic and Statistical Manual-5 Opioid Use Disorder criteria to patients receiving long-term opioid therapy (LTOT) for the management of chronic pain. This study explored perspectives on the merits of creating a new diagnostic entity to characterize the problems that arise for certain patients prescribed LTOT and develop consensus on its definition and diagnostic criteria. We conducted 3 rounds of online surveys and held one discussion-based workshop to explore a new diagnostic entity and generate consensus with subject matter experts (n = 51) in pain and opioid use disorder, including a wide range of professional disciplines. The first survey included open-ended questions and rapid qualitative analysis to identify potential diagnostic criteria. Rounds 2 and 3 involved rating potential diagnostic criteria on a Likert-type scale to achieve consensus. The workshop was a facilitated conversation aimed at further refining criteria. Three-quarters of Delphi panelists were in favor of a new diagnostic entity; consensus was reached for 19 potential diagnostic criteria including benefits of LTOT no longer outweighing harms and a criterion related to difficulty tapering. A subgroup of expert panelists further refined the new diagnostic entity definition and criteria. Consensus on potential criteria for the new diagnostic entity was reached and further refined by a subgroup of experts. This Delphi study represents the opinions of a small group of subject matter experts; perspectives from other experts and additional stakeholder groups (including patients) are warranted. (Copyright © 2022 International Association for the Study of Pain.)
Databáze:	MEDLINE
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