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Varicose Veins and Deep Venous Thrombosis—Reply

Varicose Veins and Deep Venous Thrombosis—Reply Letters Dr Bigal suggests SPACE patients had less-severe pain than ter for studying uncommon harms. Common adverse events patients prescribed opioids; however, studies suggest moder- may be viewed as minor from a clinician perspective, but are ate severity pain is typical at opioid initiation in trials and prac- relevant to patients’ experience of medication treatment. tice. In 5 trials of oxycodone controlled release (CR) spon- We agree about the importance of individualized pain care sored by Purdue, mean baseline 24-hour pain (scale range, and that our results should not be overgeneralized. SPACE results 0-10) was 6.4 (SD, 1.6). In a prospective observational study, should be used to inform individualized decision making. baseline pain (average of past-month worst, past-month av- erage, and current pain) for new regular opioid users was 6.1 Erin E. Krebs, MD, MPH (95% CI, 5.9-6.4). In SPACE, baseline pain calculated as aver- Amy Gravely, MA age of past-week worst, past-week average, and current pain Siamak Noorbaloochi, PhD was 6.1 (SD 1.4). Author Affiliations: Center for Chronic Disease Outcomes Research, We disagree with Bigal’s assertions that SPACE disadvan- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota. taged the opioid group. He incorrectly claims groups had dif- Corresponding http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Varicose Veins and Deep Venous Thrombosis—Reply

JAMA , Volume 320 (5) – Aug 7, 2018

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Publisher
American Medical Association
Copyright
Copyright 2018 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2018.7331
pmid
30088007
Publisher site
See Article on Publisher Site

Abstract

Letters Dr Bigal suggests SPACE patients had less-severe pain than ter for studying uncommon harms. Common adverse events patients prescribed opioids; however, studies suggest moder- may be viewed as minor from a clinician perspective, but are ate severity pain is typical at opioid initiation in trials and prac- relevant to patients’ experience of medication treatment. tice. In 5 trials of oxycodone controlled release (CR) spon- We agree about the importance of individualized pain care sored by Purdue, mean baseline 24-hour pain (scale range, and that our results should not be overgeneralized. SPACE results 0-10) was 6.4 (SD, 1.6). In a prospective observational study, should be used to inform individualized decision making. baseline pain (average of past-month worst, past-month av- erage, and current pain) for new regular opioid users was 6.1 Erin E. Krebs, MD, MPH (95% CI, 5.9-6.4). In SPACE, baseline pain calculated as aver- Amy Gravely, MA age of past-week worst, past-week average, and current pain Siamak Noorbaloochi, PhD was 6.1 (SD 1.4). Author Affiliations: Center for Chronic Disease Outcomes Research, We disagree with Bigal’s assertions that SPACE disadvan- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota. taged the opioid group. He incorrectly claims groups had dif- Corresponding

Journal

JAMAAmerican Medical Association

Published: Aug 7, 2018

References