Predictors of long-term opioid use among chronic nonmalignant pain patients: A register-based national open cohort study

Predictors of long-term opioid use among chronic nonmalignant pain patients: A register-based... 120Abstracts / Scandinavian Journal of Pain 12 (2016) 117–124ful to harmful and “Encounters with health care” from empoweringto humiliating.Conclusions: The suffering of women when exposed to painfulendometriosis can lead to missed opportunities in several important areas of life. Hormonal and symptomatic treatments, as well aspositive encounters of health care are important for the women’spossibility to develop working surviving strategies.http://dx.doi.org/10.1016/j.sjpain.2016.05.011Predictors of long-term opioid use amongchronic nonmalignant pain patients: Aregister-based national open cohort studyC.A. Hansen a,∗ , B. Abrahamsen bhttp://medstat.dk/ statistics for annual sales of medicines in Denmark 1996–2014.aClinic of Neuroanaesthesiology, Rigshospitalet,Copenhagen, Denmarkb Odense Patient Data Explorative, University ofSouthern Denmark, DenmarkE-mail address: carrinna.hansen.01@regionh.dk (C.A. Hansen).Aims: (1) To determine the distribution and determinants ofopioid use among chronic nonmalignant pain (CNP) patients. (2) Toidentify the patient, treatment and socioeconomic characteristicsas determinants for potential risk groups.We hypothesized that CNP patient who use opioids for morethan 1 year would differ in demographics and comorbidity fromother patients who use opioids for less than 6 months.Methods: National registers were used to include patientsbeginning opioid therapy in the period 01/01/2000–31/12/2014(incl.). The cohort consists of adults aged 16 years or older whoredeemed at least one prescription for an opioid product and residing in Denmark, analysing only patients who survived for at leasttwo years. Follow-up minimum one year after the last redeemedopioid prescription or to 31/12/2015. Participants are included atfirst redeemed prescription for an opioid product using the ATCcodes N02AA01–N02AX06. Patients were then classified as eitheropioid use for more than 1 year (group A), as opioid use for morethan 6 months but less than 1 year (group B) and opioid use equalto or less than 6 months (group C).Results: The quantity of sold opioids has been increasing during1997–2008, with a fairly stable but high level since. It is expectedthat we will be able to determine patterns and the distribution ofopioid use among CNP patients in Denmark. Consequently, describing potential risk groups of opioid use based on patient, treatment,comorbidity, socioeconomic and demographic characteristics. Dataanalysis is ongoing.Conclusions: It is expected that this study will serve as a significant supplement of existing knowledge in the area of opioidconsumption among CNP patients in Denmark. In a future perspective of prevention and health promotion initiatives of the growingpublic health problem CNP, it might be beneficial to include perspectives of risk assessment of long-term opioid use.http://dx.doi.org/10.1016/j.sjpain.2016.05.012Coupled cell networks of astrocytes andchondrocytes are target cells of inflammationElisabeth Hansson a,∗ , Eva Skiöldebrand b,caDepartment of Clinical Neuroscience andRehabilitation, Institute of Neuroscience andPhysiology, The Sahlgrenska Academy, University ofGothenburg, Swedenb Section of Pathology, Department of BiomedicalSciences and Veterinary Public Health, SwedishUniversity of Agricultural Sciences, Uppsala, Swedenc Department of Clinical Chemistry and TransfusionMedicine, Institute of Biomedicine, SahlgrenskaUniversity Hospital, Gothenburg University,Gothenburg, SwedenE-mail address: elisabeth.hansson@neuro.gu.se (E. Hansson).Aims: Systemic low-grade inflammation can be initiated in vivoafter traumatic injury or in chronic diseases as neurodegenerative, metabolic and autoimmune diseases. Coupled cell networksare target cells leading to the spread of inflammation and changesin biochemical cellular parameters. Do astrocytes and chondrocytes behave in a similar way in an inflammatory reactive state withrespect to Ca2+ signaling, actin filaments rearrangement, receptorproperties, pro-inflammatory cytokine release etc?Methods: Primary cultures of astrocytes and chondrocytes, respectively, were incubated with lipopolysaccharide (LPS) (10 ng/ml,24 h) or interleukin-1␤ (IL-1␤) (5 ng/ml, 24 h) to induce inflammatory reactivity. Ca2+ signaling, Na+ /K+ -ATPase-, connexin 43(Cx43)-, and Toll-like receptor 4 (TLR4)- expressions, actin filamentorganization, and IL-1␤ release were analyzed.Results: Stimulation with IL-1␤ or LPS altered the Ca2+ signalingfrom single peaks to oscillating waves and increased the expression of Cx43 and TLR4, and decreased expression of Na+ /K+ -ATPase.A disruption of the actin filaments with more pronounced ringformed structures was found in inflammatory induced astrocytesand chondrocytes which in turn affects Ca2+ oscillations. Additionally a release of active matrix metallopeptidase-13 was found inmedia from IL-1␤ stimulated chondrocytes.Conclusions: Our data show that cellular mechanisms ofhealthy chondrocytes as well as inflamed, resemble the coupledcell networks of astrocytes. Chronic, low-grade inflammation caninfluence coupled cell networks in one or several organs, leading toco-morbidity. It is crucial that inflammatory affected cells in various http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Predictors of long-term opioid use among chronic nonmalignant pain patients: A register-based national open cohort study

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de Gruyter
Copyright
© 2016 Scandinavian Association for the Study of Pain
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1877-8860
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1877-8879
D.O.I.
10.1016/j.sjpain.2016.05.012
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Abstract

120Abstracts / Scandinavian Journal of Pain 12 (2016) 117–124ful to harmful and “Encounters with health care” from empoweringto humiliating.Conclusions: The suffering of women when exposed to painfulendometriosis can lead to missed opportunities in several important areas of life. Hormonal and symptomatic treatments, as well aspositive encounters of health care are important for the women’spossibility to develop working surviving strategies.http://dx.doi.org/10.1016/j.sjpain.2016.05.011Predictors of long-term opioid use amongchronic nonmalignant pain patients: Aregister-based national open cohort studyC.A. Hansen a,∗ , B. Abrahamsen bhttp://medstat.dk/ statistics for annual sales of medicines in Denmark 1996–2014.aClinic of Neuroanaesthesiology, Rigshospitalet,Copenhagen, Denmarkb Odense Patient Data Explorative, University ofSouthern Denmark, DenmarkE-mail address: carrinna.hansen.01@regionh.dk (C.A. Hansen).Aims: (1) To determine the distribution and determinants ofopioid use among chronic nonmalignant pain (CNP) patients. (2) Toidentify the patient, treatment and socioeconomic characteristicsas determinants for potential risk groups.We hypothesized that CNP patient who use opioids for morethan 1 year would differ in demographics and comorbidity fromother patients who use opioids for less than 6 months.Methods: National registers were used to include patientsbeginning opioid therapy in the period 01/01/2000–31/12/2014(incl.). The cohort consists of adults aged 16 years or older whoredeemed at least one prescription for an opioid product and residing in Denmark, analysing only patients who survived for at leasttwo years. Follow-up minimum one year after the last redeemedopioid prescription or to 31/12/2015. Participants are included atfirst redeemed prescription for an opioid product using the ATCcodes N02AA01–N02AX06. Patients were then classified as eitheropioid use for more than 1 year (group A), as opioid use for morethan 6 months but less than 1 year (group B) and opioid use equalto or less than 6 months (group C).Results: The quantity of sold opioids has been increasing during1997–2008, with a fairly stable but high level since. It is expectedthat we will be able to determine patterns and the distribution ofopioid use among CNP patients in Denmark. Consequently, describing potential risk groups of opioid use based on patient, treatment,comorbidity, socioeconomic and demographic characteristics. Dataanalysis is ongoing.Conclusions: It is expected that this study will serve as a significant supplement of existing knowledge in the area of opioidconsumption among CNP patients in Denmark. In a future perspective of prevention and health promotion initiatives of the growingpublic health problem CNP, it might be beneficial to include perspectives of risk assessment of long-term opioid use.http://dx.doi.org/10.1016/j.sjpain.2016.05.012Coupled cell networks of astrocytes andchondrocytes are target cells of inflammationElisabeth Hansson a,∗ , Eva Skiöldebrand b,caDepartment of Clinical Neuroscience andRehabilitation, Institute of Neuroscience andPhysiology, The Sahlgrenska Academy, University ofGothenburg, Swedenb Section of Pathology, Department of BiomedicalSciences and Veterinary Public Health, SwedishUniversity of Agricultural Sciences, Uppsala, Swedenc Department of Clinical Chemistry and TransfusionMedicine, Institute of Biomedicine, SahlgrenskaUniversity Hospital, Gothenburg University,Gothenburg, SwedenE-mail address: elisabeth.hansson@neuro.gu.se (E. Hansson).Aims: Systemic low-grade inflammation can be initiated in vivoafter traumatic injury or in chronic diseases as neurodegenerative, metabolic and autoimmune diseases. Coupled cell networksare target cells leading to the spread of inflammation and changesin biochemical cellular parameters. Do astrocytes and chondrocytes behave in a similar way in an inflammatory reactive state withrespect to Ca2+ signaling, actin filaments rearrangement, receptorproperties, pro-inflammatory cytokine release etc?Methods: Primary cultures of astrocytes and chondrocytes, respectively, were incubated with lipopolysaccharide (LPS) (10 ng/ml,24 h) or interleukin-1␤ (IL-1␤) (5 ng/ml, 24 h) to induce inflammatory reactivity. Ca2+ signaling, Na+ /K+ -ATPase-, connexin 43(Cx43)-, and Toll-like receptor 4 (TLR4)- expressions, actin filamentorganization, and IL-1␤ release were analyzed.Results: Stimulation with IL-1␤ or LPS altered the Ca2+ signalingfrom single peaks to oscillating waves and increased the expression of Cx43 and TLR4, and decreased expression of Na+ /K+ -ATPase.A disruption of the actin filaments with more pronounced ringformed structures was found in inflammatory induced astrocytesand chondrocytes which in turn affects Ca2+ oscillations. Additionally a release of active matrix metallopeptidase-13 was found inmedia from IL-1␤ stimulated chondrocytes.Conclusions: Our data show that cellular mechanisms ofhealthy chondrocytes as well as inflamed, resemble the coupledcell networks of astrocytes. Chronic, low-grade inflammation caninfluence coupled cell networks in one or several organs, leading toco-morbidity. It is crucial that inflammatory affected cells in various

Journal

Scandinavian Journal of Painde Gruyter

Published: Jul 1, 2016

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