Low-dose 7-day transdermal buprenorphine in daily clinical practice - perceptions of elderly patients with moderate non-malignant chronic pain

• Published in: Current medical research and opinion Vol. 28; no. 10; p. 1585
• Main Authors: Uberall, Michael A, Müller-Schwefe, Gerhard H H
• Format: Journal Article
• Language: English
• Published: England 01.10.2012
• Subjects: Administration, Cutaneous; Aged; Aged, 80 and over; Analgesics, Opioid - administration & dosage; Buprenorphine - administration & dosage; Chronic Pain - drug therapy; Chronic Pain - epidemiology; Chronic Pain - physiopathology; Female; Follow-Up Studies; Germany - epidemiology; Humans; Male; Pain Management; Patient Satisfaction; Surveys and Questionnaires; Germany
• ISSN: 1473-4877
• DOI: 10.1185/03007995.2012.731387

To assess patients' perceptions regarding the low-dose 7-day buprenorphine transdermal patch for treatment of moderate non-malignant chronic pain. Patient-reported outcome data were collected in clinical practices in Germany in a prospective, multicenter, non-interventional observation using the German Pain Questionnaire/German Pain Diary. Questionnaires were completed by the patients without influence from the attending physician. Mean change in pain intensity (lowest, average, and highest pain intensity in the previous 24 h), changes in Hospital Anxiety and Depression Scale scores (HADS-A and HADS-D), in impairments of daily activities (modified pain disability index, mPDI), in quality of life (quality of life impairment by pain inventory, QLIP), and in overall burden of pain over a 12-week treatment period were evaluated. Data of 891 patients were assessed (mean age 72.8 years). Buprenorphine starting doses were mainly 5 µg/h (67.1% of patients) and 10 µg/h (27.3%). At the end of week 12, the majority received either 5 µg/h (41%) or 10 µg/h (42.3%) buprenorphine. Mean average pain intensity was reduced by 5.1 points to 1.7 ± 1.3 from 6.8 ± 1.5 points at baseline (76% improvement). Amelioration was observed in HADS-A (59% from 7.8 ± 3.3 at baseline) and HADS-D (56% from 9.2 ± 3.1), in mPDI sum score (76%; from 31.1 ± 9.8), and in quality of life (165%; from 13.9 ± 10.1). Mean burden of pain continuously decreased. All those inherent in open-label observations and pain studies using subjective and patient-reported outcome parameters (such as the lack of a control group). Our results indicate that the 7-day buprenorphine patch might be considered an effective treatment option for moderate non-malignant chronic pain management in daily clinical practice. The mostly elderly patient population of this patient survey experienced sustained pain relief and improvements in pain-related impairments of daily activities and quality of life, leading to a substantial reduction in overall burden of pain.