South Tees Hospitals NHS Foundation Trust and the University of Warwick have developed a support programme that they hope will help people with long term pain reduce their dependency on opioids and improve their quality of life.
The trial, funded from the NIHR Health Technology Assessment Programme, is being led by Professor Sam Eldabe, a Consultant in Pain Medicine at The James Cook University Hospital and Dr Harbinder Sandhu, Associate Professor from Warwick Medical School.
Dr Sandhu said: “Evidence suggests that opioids are only effective in the short term and patients take them long term then need to manage a range of side effects and can suffer devastating withdrawal symptoms.
“However in the UK reports indicate that between 2000-2010 prescriptions of opioids for noncancer pain increased by 466% and in 2015 there were 16 million opioid prescriptions costing over £200 million. We hope that the results of our study will be used to help patients with long-term pain in the future.”
The study will compare two treatments:
- Existing GP care, plus a self-help booklet and relaxation CD or
- GP care plus a specifically designed group and one-to-one support programme developed at Warwick Medical School with input from the collaborative study team
Researchers will measure the everyday functioning and opioid use of the 468 volunteers taking part in the I-WOTCH (Improving the Wellbeing of People with Opioid Treated Chronic Pain) study.
The intervention is targeting patients using strong pain killers up to and including Tramadol for the treatment of persistent non-cancer pain which account for 95% of strong opioids prescribed in the UK within primary care.
Participants will be randomly divided into two groups: one will have access to the usual GP care plus an information booklet and a relaxation CD; the second will be given the same and also take part in a support programme led by a research nurse and a trained lay person who has chronic pain but has reduced their opioids intake.
The course includes sessions such as coping techniques, stress management, goal setting, mindfulness, posture and movement advice, how to manage any withdrawal symptoms, and pain control after opioids
Both groups will keep a diary for four months to provide important information about quality of life and any withdrawal symptoms, as well as completing questionnaires about their everyday functioning and pain killer intake at intervals throughout the trial.
Professor Eldabe added: “Our clinical experience of helping people who wished to come off strong pain killers is that the great majority feel much better in themselves, are better able to interact with their families, become more outgoing and active and perhaps surprisingly complain of no more pain than when they were taking the pain killers.”
The intervention will run in in three locations - North East England, North East London and the West Midlands – with the 468 participants being recruited from around 100 general practices and community pain/musculoskeletal services.