20.500.12556/DKUM-89886 European* clinical practice recommendations on opioids for chronic noncancer pain - Part 1 role of opioids in the management of chronic noncancer pain Background: Opioid use for chronic non-cancer pain (CNCP) is complex. In the absence of pan-European guidance on this issue, a position paper was commissioned by the European Pain Federation (EFIC). Methods: The clinical practice recommendations were developed by eight scientific societies and one patient self-help organization under the coordination of EFIC. A systematic literature search in MEDLINE (up until January 2020) was performed. Two categories of guidance are given: Evidence-based recommendations (supported by evidence from systematic reviews of randomized controlled trials or of observational studies) and Good Clinical Practice (GCP) statements (supported either by indirect evidence or by case-series, case-control studies and clinical experience). The GRADE system was applied to move from evidence to recommendations. The recommendations and GCP statements were developed by a multiprofessional task force (including nursing, service users, physicians, physiotherapy and psychology) and formal multistep procedures to reach a set of consensus recommendations. The clinical practice recommendations were reviewed by five external reviewers from North America and Europe and were also posted for public comment. Results: The key clinical practice recommendations suggest: (a) first optimizing established non-pharmacological treatments and non-opioid analgesics and (b) considering opioid treatment if established non-pharmacological treatments or non-opioid analgesics are not effective and/or not tolerated and/or contraindicated. Evidence- and clinical consensus-based potential indications and contraindications for opioid treatment are presented. Eighteen GCP recommendations give guidance regarding clinical evaluation, as well as opioid treatment assessment, monitoring, continuation and discontinuation. Conclusions: Opioids remain a treatment option for some selected patients with CNCP under careful surveillance. Significance: In chronic pain, opioids are neither a universal cure nor a universally dangerous weapon. They should only be used for some selected chronic noncancer pain syndromes if established non-pharmacological and pharmacological treatment options have failed in supervised pain patients as part of a comprehensive, multi-modal, multi-disciplinary approach to treatment. In this context alone, opioid therapy can be a useful tool in achieving and maintaining an optimal level of pain control in some patients. pain cronic disease analgesia opioid analgesics bolečina kronične bolezni analgezija opoidni analgetiki true false true Wiley Angleški jezik Slovenski jezik Znanstveno delo 2024-08-16 10:11:03 2024-08-16 11:06:25 2024-08-17 03:47:13 0000-00-00 00:00:00 2021 0 0 Str. 949-968 Št. 5 Letn. 25 May 2021 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 2021-03-02 616.8-009.7 53758467 10.1002/ejp.1736 1532-2149 Häuser-2021-European__clinical_practice_recomm.pdf Häuser-2021-European__clinical_practice_recomm.pdf 1 C44161E5E2E50426D07F27BB863E8C02 78c74758a509db7f3b28f4e8ba037a380b4749b57a551a087232e05647d54131 df699d35-5bad-11ef-acc3-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=182516 https://doi.org/10.1002/ejp.1736 1 27a0e043-5ba7-11ef-acc3-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=182510 Medicinska fakulteta 0 0 0