Purpose: Among industrialized countries, Canada has the second-highest opioid prescribing rate for pain management. Physiotherapy and occupational therapy interventions are potential non-pharmacological alternatives. We undertook a scoping review to explore and summarize the current evidence describing the interventions included or used in physiotherapy and occupational therapy in opioid tapering for individuals with chronic pain. Method: A systematic search of the peer-reviewed health databases was conducted, with data synthesis guided by Arksey and O'Malley's scoping review methodology. Articles were included in the narrative synthesis if (1) interventions within the scope of practice for physiotherapists or occupational therapists were described or these professionals were part of interdisciplinary care and (2) opioid tapering or reduction was addressed. Results: The 39 articles identified included 2 systematic reviews, 9 narrative reviews or commentaries, 2 case reports, 11 uncontrolled cohort studies, 1 cross-sectional study, 5 randomized controlled trials, 4 programme evaluations, and 4 qualitative studies. Of the 28 studies reporting specific outcomes, 25 reported positive outcomes of rehabilitation interventions for opioid tapering. There was greater representation of interventions from physiotherapy than from occupational therapy: few articles contained substantive descriptions (e.g., dosage and duration). Conclusions: The evidence to guide therapists in supporting opioid tapering for people with chronic pain seems to be limited. Further research is needed to establish effectiveness for stand-alone interventions and as part of a comprehensive rehabilitation approach.
Purpose: Among industrialized countries, Canada has the second-highest opioid prescribing rate for pain management. Physiotherapy and occupational therapy interventions are potential non-pharmacological alternatives. We undertook a scoping review to explore and summarize the current evidence describing the interventions included or used in physiotherapy and occupational therapy in opioid tapering for individuals with chronic pain. Method: A systematic search of the peer-reviewed health databases was conducted, with data synthesis guided by Arksey and O'Malley's scoping review methodology. Articles were included in the narrative synthesis if (1) interventions within the scope of practice for physiotherapists or occupational therapists were described or these professionals were part of interdisciplinary care and (2) opioid tapering or reduction was addressed. Results: The 39 articles identified included 2 systematic reviews, 9 narrative reviews or commentaries, 2 case reports, 11 uncontrolled cohort studies, 1 cross-sectional study, 5 randomized controlled trials, 4 programme evaluations, and 4 qualitative studies. Of the 28 studies reporting specific outcomes, 25 reported positive outcomes of rehabilitation interventions for opioid tapering. There was greater representation of interventions from physiotherapy than from occupational therapy: few articles contained substantive descriptions (e.g., dosage and duration). Conclusions: The evidence to guide therapists in supporting opioid tapering for people with chronic pain seems to be limited. Further research is needed to establish effectiveness for stand-alone interventions and as part of a comprehensive rehabilitation approach.
Authors: Jason W Busse; Li Wang; Mostafa Kamaleldin; Samantha Craigie; John J Riva; Luis Montoya; Sohail M Mulla; Luciane C Lopes; Nicole Vogel; Eric Chen; Karin Kirmayr; Kyle De Oliveira; Lori Olivieri; Alka Kaushal; Luis E Chaparro; Inna Oyberman; Arnav Agarwal; Rachel Couban; Ludwig Tsoi; Tommy Lam; Per Olav Vandvik; Sandy Hsu; Malgorzata M Bala; Stefan Schandelmaier; Anne Scheidecker; Shanil Ebrahim; Vahid Ashoorion; Yasir Rehman; Patrick J Hong; Stephanie Ross; Bradley C Johnston; Regina Kunz; Xin Sun; Norman Buckley; Daniel I Sessler; Gordon H Guyatt Journal: JAMA Date: 2018-12-18 Impact factor: 56.272
Authors: Marianne S Matthias; Nicole L Johnson; Cleveland G Shields; Matthew J Bair; Palmer MacKie; Monica Huffman; Stewart C Alexander Journal: J Pain Date: 2017-07-08 Impact factor: 5.820
Authors: Alyson K Kwok; Nathan N O'Hara; Andrew N Pollak; Lyndsay M O'Hara; Alexandra Herman; Christopher J Welsh; Gerard P Slobogean Journal: BMC Health Serv Res Date: 2019-01-14 Impact factor: 2.655