Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Time for change

an experimental investigation of chronic pain patients' emotional and attitudinal responses to simulated opioid-tapering advice

Ashton-James, Claire E.*; Chemke-Dreyfus, Axel; Costa, Daniel; Glare, Paul

doi: 10.1097/j.pain.0000000000001543
Research Paper
Buy
SDC
Editor's Choice
Video

Clinicians report reluctance to deliver opioid-tapering advice to patients with chronic pain, in part due to concerns that patients will be angry and dissatisfied. An experiment was conducted to examine chronic pain patients' emotional and attitudinal responses to simulated opioid-tapering advice. Patients scheduled for an initial assessment at a tertiary pain clinic and currently taking opioid medications for pain (N = 196) were randomly assigned to view video footage of a standardized patient receiving 1 of 3 forms of treatment advice: (1) stay on current medication (2) change to a different pain medication, or (3) taper off pain medications and participate in a CBT-based pain self-management program. Participants reported how positive/enthusiastic, anxious/worried, and angry/irritable they felt in response to the simulated treatment advice, and how satisfied with and willing they would be to accept and follow the advice. Participants expressed more positive emotional and attitudinal responses to simulated opioid-tapering advice than to simulated opioid-maintenance advice. Furthermore, participants' responses to simulated opioid-tapering and opioid-change advice were not significantly different, suggesting that participants responded positively to the prospect of change in treatment strategy. Additional analyses revealed that participants with a longer history of chronic pain and opioid use responded less positively to simulated opioid-tapering advice. The results of this study contribute to our understanding of factors that may shape chronic pain patients' responses to opioid-tapering advice and suggest that patients may respond more positively to opioid-tapering advice if it is presented together with an alternative treatment approach.

Patients with chronic pain responded favourably to simulated treatment advice scenarios involving a change in treatment approach, even when this change involved opioid tapering.

Faculty of Medicine and Health, Pain Management Research Institute, The University of Sydney, Sydney, Australia

Corresponding author. Address: Faculty of medicine and Health, Pain Management Research Institute, The University of Sydney, Lvl 2 Douglas Building, Royal North Shore Hospital, St Leonards, Australia 2065. Tel.: +61 2 94631528. E-mail address: Claire.ashton-james@sydney.edu.au (C.E. Ashton-James).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).

Received October 22, 2018

Received in revised form December 31, 2018

Accepted January 16, 2019

© 2019 International Association for the Study of Pain
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website