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Expectations and analgesic preferences among participants in a 12-month trial comparing opioid versus non-opioid analgesics for chronic pain.

Krebs EE, Gravely AA, Jensen AC, Bair M, Kroenke K. Expectations and analgesic preferences among participants in a 12-month trial comparing opioid versus non-opioid analgesics for chronic pain. Poster session presented at: American Academy of Pain Medicine Annual Meeting; 2016 Feb 20; Palm Springs, CA.




Abstract:

Introduction: The Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) Trial is an ongoing randomized pragmatic trial comparing benefits and harms of opioid versus non-opioid analgesics over 12 months. The objective of this report is to describe participants' baseline outcome expectations and analgesic arm assignment preferences and to examine the relationship of arm preference with perceptions of analgesic effectiveness and safety. Methods: Procedures are IRB-approved. Eligibility criteria include chronic back or hip/knee osteoarthritis pain of at least moderate severity and no current long-term opioids. Potential participants were identified through computerized records and screened by telephone. After consent and before randomization, participants completed ratings of expectations for personal benefit from study participation (0 least to 10 most), preference for study arm assignment (opioid, non-opioid, or unsure/none), strength of preference, and perceptions of opioid and non-opioid analgesic effectiveness and safety (0 least to 10 most). Ratings were compared using ANOVA and chi-square tests. Results: Of the first 195 participants, 33% preferred the opioid arm, 20% preferred the non-opioid arm, and 47% were unsure/no preference. Strength of preference did not differ by arm preference (p = 0.418). Expectations of personal benefit were high overall (mean 7.4, SD 2.0) and did not differ by arm preference (p = 0.219). The table shows associations of arm preference with analgesic effectiveness and safety perceptions. Conclusions: Expectations for personal benefit were high overall. Compared with those who preferred the non-opioid arm or had no arm preference, participants who preferred the opioid arm rated opioids higher on safety and non-opioids lower on effectiveness.





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