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J Rehabil Med 2019; 51: 719–720 Cochrane Corner rehabilitation.cochrane.org ARE THERE EFFECTIVE INTERVENTIONS FOR REDUCING THE USE OF PRESCRIBED OPIOIDS IN ADULTS WITH CHRONIC NON-CANCER PAIN? – A COCHRANE REVIEW SUMMARY WITH COMMENTARY Chiara ARIENTI From the IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy. The aim of this commentary is to discuss the publis- hed Cochrane Review “Interventions for the reduc- tion of prescribed opioid use in chronic non-cancer pain” by Eccleston C, Fisher E, Thomas KH, Hearn L, Derry S, Stannard C, Knaggs R, Moore RA (1) from a rehabilitation perspective. This Cochrane Corner is produced in agreement with Journal of Rehabilita- tion Medicine by Cochrane Rehabilitation 1 Key word: Opioid; Pain; Cognitive therapy; Rehabilitation; Cochrane Review Summary. J Rehabil Med 2019; 51: 719–720 Correspondence address: Chiara Arienti, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy. E-mail: [email protected] BACKGROUND Chronic non-cancer pain (CNCP) is a common condition with prevalence rates as high as 33% of the population in western population and its optimal management is crucial to the health and wellbeing of the community. Opioids have long been used for acute and cancer pain and in the last two decades they have also been prescribed for CNCP (2). The 2012 American guidelines for responsible opioid prescribing in CNCP gave recommendations for ensuring the appropriate management of CNCP, and minimizing abuse of opioids and important side effects, such as tolerance and dependence (3). Sedation, impaired cognitive function, depression, constipation, and bladder dysfunction are common during opioid therapy (4). For these reasons, professional societies worldwide have This summary is based on a Cochrane Review previously published in the Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.: CD010323. DOI: 10.1002/14651858.CD010323.pub3. (see www. cochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and Cochrane Database of Systematic Reviews should be consulted for the most recent version of the review. The views expressed in the summary with commentary are those of the Cochrane Corner author(s) and do not represent the Cochrane Library, the Cochrane Pain, Palliative and Supportive Care Review Group, or Wiley. produced guidance advocating/promoting the judicious and careful use of opioids. Rehabilitation professionals who treat CNCP in rehabilitation settings should know the effectiveness or not of different methods to reduce the use of prescribed opioids for CNCP discussed in this review. INTERVENTIONS FOR THE REDUCTION OF PRESCRIBED OPIOID USE IN CHRONIC NON- CANCER PAIN (Eccleston C, Fisher E, Thomas KH, Hearn L, Derry S, Stannard C, Knaggs R, Moore RA, 2017) WHAT IS THE AIM OF THIS COCHRANE REVIEW? The aim of this Cochrane Review was to investigate the effectiveness of different methods designed to achieve reduction or cessation of prescribed opioid use for the management of CNCP in adults compared to controls. WHAT WAS STUDIED IN THE COCHRANE REVIEW? The review included adults (18 years of age or older) using prescription opioids for management of CNCP lasting for 3 months or more. The interventions studied were all that aimed to dose reduction or cessation . The primary outcomes were prescribed opioid use and adverse events (AEs) related to opioid reduction. Secondary outcomes were pain intensity/severity, psychological functioning, and physical functioning. 1 SEARCH METHODOLOGY AND SEARCH DATE OF THE COCHRANE REVIEW The review authors searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase for studies published up to 4 January 2017. There were no language restrictions and www.clinicaltrials.gov was searched for ongoing studies. This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977 doi: 10.2340/16501977-2608