Predictors of Long-Term Opioid Effectiveness in Patients With Chronic Non-Cancer Pain Attending Multidisciplinary Pain Treatment Clinics: A Quebec Pain Registry Study

Pain Pract. 2020 Jul;20(6):588-599. doi: 10.1111/papr.12883. Epub 2020 Apr 8.


Objective: This study aimed to identify characteristics of individuals who are most likely to benefit from long-term opioid therapy in terms of reduction in pain severity and improved mental health-related quality of life (mQoL) without considering potential risks.

Methods: This was a retrospective cohort study of 116 patients (age = 51.3 ± 12.5 years, male = 42.2%) enrolled in the Quebec Pain Registry between 2008 and 2011 and who initiated opioid therapy after their first appointment in a multidisciplinary pain clinic and persisted with this treatment for at least 12 months. Clinically significant improvement was defined as a 2-point decrease on the PEG (pain, enjoyment of life, and general activity) Scale of pain severity (scored from 0 to 10) at 12-month follow-up and a 10-point increase on the Short-Form-12 Health Survey version 2 (SF12-v2) Mental Health-Related Quality of Life Summary Scale, which corresponds to 1 standard deviation (SD) of the mean in the general population (mean = 50, SD = 10).

Results: Clinically significant reduction in pain severity was observed in 26.7% of patients, while improvement in mQoL was reported by 20.2% of patients on long-term opioid therapy. Older age (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.0 to 1.08; P = 0.032) and alcohol or drug problems (OR = 0.26; 95% CI: 0.07 to 0.96; P = 0.044) were weakly associated with pain severity at 12-month follow-up. Baseline higher pain severity (OR = 0.62; 95% CI: 0.43 to 0.91; P = 0.014) and baseline higher mQoL (OR = 0.89; 95% CI: 0.83 to 0.95; P = 0.001) were associated with non-improvement in mQoL.

Conclusion: The analysis failed to identify clinically meaningful predictors of opioid therapy effectiveness, making it difficult to inform clinicians about which patients with chronic non-cancer pain are most likely to benefit from long-term opioid therapy.

Keywords: Quebec Pain Registry; chronic pain; effectiveness; opioids; quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analgesics, Opioid / therapeutic use*
  • Chronic Pain / drug therapy*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Clinics*
  • Quality of Life
  • Quebec
  • Registries
  • Retrospective Studies
  • Treatment Outcome


  • Analgesics, Opioid