Improved Treatment for Patients With Long-term Opioid Therapy for Non-cancer Pain in Primary Care
Improved Treatment for Patients With Long-term Opioid Therapy for Non-cancer Pain in Primary Care (Opi-Prim)
Uppsala County Council, Sweden
110 participants
Mar 10, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to reduce inappropriate long term opioid treatment (LTOT) and to optimize pain management in patients with LTOT for chronic non-cancer pain in primary care through a new person-centred and team-based approach. The main question it aims to answer is: What are the effects of a new person-centred and team-based approach on pain interference in patients with LTOT for chronic non-cancer pain in primary care? Researchers will compare a new person-centred and team-based approach to usual care to see if pain interference is lower. Participants will receive a person-centred team-based treatment consisting of: * Phase 1 (investigation and assessment, week 1-3): A medication review, pain analysis and other assessments through separate visits to a pharmacist, general practitioner, physiotherapist, psychologist and care manager * Phase 2 (treatment plan, week 3-4): A team consultations with all healthcare personnel involved in Phase 1 including the patient where an individualized rehabilitation plan is made based. * Phase 3 (treatment and follow-up, week 4-24): Implementation of the individualized rehabilitation plan with frequent follow-up contacts (1 per 1-3 weeks) by phone with the care manager.
Eligibility
Inclusion Criteria2
- Having received the equivalent of 90 days or more prescription of opioids for chronic pain made by the general practitioner during the recent 12 months
- Able to speak Swedish or English
Exclusion Criteria3
- Having been referred to a pain clinic (either at hospital or multimodal rehabilitation in primary care) within the last 6 months
- No current opioid use, severe cognitive dysfunction, e.g., suicidal ideation, psychotic symptoms, or dementia, that prevents informed consent.
- Using their opioids for cancer pain
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Interventions
Phase 1 (investigation and assessment, week 1-3): * A medication review focusing on pain, sleep and depression/anxiety disorders by a pharmacist. * A thorough pain analysis by a GP according to existing guidelines including duration of pain, pain localization and pain mechanisms. * A visit to a physiotherapist for evaluation and assessment of possible treatment regarding physical exercise/physical activities. * A visit to a psychologist for diagnostics and treatments regarding psychological and social factors. * A visit to a care manager Phase 2 (treatment plan, week 3-4): \- A team consultation with all healthcare personnel involved in Phase 1 including the patient where an individualized rehabilitation plan is made. Phase 3 (treatment and follow-up, week 4-24): * Implementation of the individualized rehabilitation plan. * Frequent follow-up contacts (1 per 1-3 weeks) by phone with an established contact person, i.e. care manager. * A second team consultation half-way
Locations(1)
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NCT06856733