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MEDTECH The Power of Multimodal Interventions: A New Hope for Chronic Pain Patients in the Opioid Crisis
A groundbreaking trial, Improving the Wellbeing of people with Opioid Treated Chronic Pain (I-WOTCH), conducted by the University of Warwick and the James Cook University Hospital provides new insight into multimodal interventions to reduce opioid use in managing chronic nonmalignant pain, with notable implications for mental health and overall patient wellbeing.
Population:
- The trial included 608 adult participants across 191 primary care centers in England from 2017 to 2019.
- Participants, mean age 61, were predominantly white (96%) and female (60%) long-term opioid users for managing nonmalignant pain.
Study Method:
- The researchers divided participants into two groups, interevention and usual care, both receiving educational resources about opioid use.
- The intervention group received additional support, including group sessions and individual care, to encourage opioid cessation.
- Primary and secondary outcomes, like opioid usage and emotional wellbeing, were measured at the 12-month follow-up point.
Main Outcomes:
- 29% of participants in the intervention group ceased opioid use at 12 months, compared to 7% in the usual care group.
- 57% of participants in the intervention group and 27% in the usual care group reduced their daily MED by 50% or more from baseline.
- After four months, the intervention group showed significant improvements in mental health, pain self-efficacy, and health-related quality of life
- There were no significant differences between the intervention and the usual care group regarding pain intensity, opioid withdrawal symptoms, or sleep quality.
Summary:
- The I-WOTCH trial, conducted by UK researchers, effectively demonstrated that a multimodal approach could significantly reduce opioid usage in chronic pain patients. This intervention also improved patients’ mental health and overall life quality.
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“Our study shows clearly that opioids can be gradually reduced and stopped with no actual worsening of the pain. This confirms our suspicions that opioids have very little long-term impact on persistent pain.”
Professor Sam Eldabe, clinical trial co-lead and Consultant in Pain Medicine at the James Cook University Hospital
