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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

Preventing an Opioid Epidemic In Norway: Focusing on Treatment of Chronic pain (POINT)

Alternative title: Hvordan unngå en opioidepidemi i Norge: Fokus på behandling av kroniske smerter

Awarded: NOK 16.0 mill.

Patients with chronic pain need good treatment. The use of opioids for chronic, non-malignant pain may seem appropriate in the short term, but can often have negative consequences for both the individual and society in the long term. In addition, there is a lack of a robust knowledge base showing the effectiveness of long-term opioid treatment for chronic pain. Negative consequences associated with long-term use are serious side effects, such as the risk of overdose and the development of addiction. The ongoing opioid epidemic in the United States, caused by over-prescribing of opioids to pain patients, has led to dramatic health and social consequences. The overall goal of the POINT project is to provide knowledge to optimize the treatment of patients with chronic pain in order to avoid unnecessary escalation of opioid use. The goal is that in the long run this will prevent unwanted consequences of opioid treatment and increase patients' quality of life. In the end, the project will hopefully prevent an opioid epidemic in Norway. To achieve our main goal, we will focus on pain patients and their physicians, as increasing opioid use develops in the interaction between patient and physician. We will use both quantitative and qualitative methods. Data from national registers will be used to identify risk factors for and consequences of long-term opioid use. Using qualitative methods, we will systematize, describe and explain the patients' and physicians' perspectives on opioid treatment and improve communication between patient and physician. The project will evaluate the effect of a knowledge-based training intervention aimed at general practitioners. In addition, the project will develop and test two non-pharmacological interventions that consist of an interdisciplinary group treatment and an e-health program. Communication between patient and physician as well as between different caregivers will be in focus.

The ongoing opioid epidemic in the USA – caused by inappropriate prescribing of opioids to pain patients – has led to dramatic health and societal consequences. Several factors, the escalating use of opioids to chronic pain patients, the increasing use of strong opioids in particular, and the increasing number of overdoses caused by prescription opioids – point to the start of an opioid epidemic in Norway. Surprisingly, we know little about how patients who develop long-term opioid use in Norway differ from those who quit after shorter treatments. Our understanding of the complex mechanisms behind opioids role in chronic pain alleviation is also poor. We need more knowledge of how to optimize treatment to chronic pain patients to reduce the disease burden, and the societal burden. The overall objective of the POINT-project is to help opioid prescribers optimize treatment for chronic pain patients to reduce pain without escalating opioid treatment, to prevent adverse consequences of opioid treatment, and to increase patients’ quality of life - to ultimately prevent an opioid epidemic in Norway. To achieve our main objective, we will focus on pain patients and their doctors, as escalating opioid use develops in their interaction. We will use a mixed methods approach and complementary data sources. Data from nationwide registries will be used to identify risk factors for long-term opioid use and consequences. By using qualitative methods and surveys we will systematize, describe and explain the patients’ and prescribers' perspectives on opioid treatment as well as communication between all invoked parties. The project will evaluate the effect of a knowledge-based update visits intervention directed towards general practitioners, and develop and test two interventions: a community-based group treatment and a self-guided e-health program. Communication between patient and prescribe as well as between care givers will be in focus.

Activity:

BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering