Rice JB, White AG, Birnbaum HG, et al. A model toidentify patients at risk for prescription <strong>opioid</strong> abuse,dependence, and misuse. Pain Med. 2012;13(9):1162-73.PMID: 22845054. Excluded: wrong study design.Richardson LP, Russo JE, Katon W, et al. Mental healthdisorders and long-term <strong>opioid</strong> use among adolescents andyoung adults with <strong>chronic</strong> <strong>pain</strong>. J Adolesc Health.2012;50(6):553-8. PMID: 22626480. Excluded: wrongstudy design.Richarz U, Waechter S, Sabatowski R, et al. Sustainedsafety and efficacy of once-daily hydromorphone extendedrelease(OROS hydromorphone ER) compared with twicedailyoxycodone controlled-release over 52 weeks inpatients with moderate to severe <strong>chronic</strong> noncancer <strong>pain</strong>.Pain Pract. 2013;13(1):30-40. PMID: 22510252. Excluded:wrong comparator.Riemsma R, Forbes C, Harker J, et al. Systematic review oftapentadol in <strong>chronic</strong> severe <strong>pain</strong>. Curr Med Res Opin.2011;27(10):1907-30. PMID: 21905968. Excluded: wrongpopulation.Riley J, Ross JR, Rutter D, et al. No <strong>pain</strong> relief frommorphine? individual variation in sensitivity to morphineand the need to switch to an alternative <strong>opioid</strong> in cancerpatients. Support Care Cancer. 2006;14(1):56-64. PMID:15952009. Excluded: inadequate duration.Riley JL, Hastie BA, Glover TL, et al. Cognitive-affectiveand somatic side effects of morphine and pentazocine: sideeffectprofiles in healthy adults. Pain Med. 2010;11(2):195-206. PMID: 19671086. Excluded: wrong intervention.Ringe JD, Schafer S, Wimmer AM, et al. Use of OROShydromorphone in the <strong>treatment</strong> of osteoarthritis andosteoporosis: a pooled analysis of three non-interventionalstudies focusing on different starting doses. Wien KlinWochenschr. 2012;124(1-2):25-31. PMID: 22045112.Excluded: inadequate duration.Ripamonti C, Groff L, Brunelli C, et al. Switching frommorphine to oral methadone in treating cancer <strong>pain</strong>: what isthe equianalgesic dose ratio? J Clin Oncol.1998;16(10):3216-21. PMID: 9779694. Excluded: wrongstudy design.Robbins L. Long-acting <strong>opioid</strong>s for severe <strong>chronic</strong> dailyheadache. Headache Q-curr Trea. 1999;10(2):135-9. PMID:N/A. Excluded: wrong comparator.Robinson RC, Gatchel RJ, Polatin P, et al. Screening forproblematic prescription <strong>opioid</strong> use. Clin J Pain.2001;17(3):220-8. PMID: 11587112. Excluded: wrongpublication type.Robinson-Papp J, Elliott K, Simpson DM, et al.Problematic prescription <strong>opioid</strong> use in an HIV-infectedcohort: the importance of universal toxicology testing. JAcquir Immune Defic Syndr. 2012;61(2):187-93. PMID:22820804. Excluded: wrong study design.Rodriguez M, Barutell C, Rull M, et al. Efficacy andtolerance of oral dipyrone versus oral morphine for cancer<strong>pain</strong>. Eur J Cancer. 1994;30A(5):584-7. PMID: 8080670.Excluded: inadequate duration.Rodriguez RF, Castillo JM, Castillo MP, et al.Hydrocodone/acetaminophen and tramadol chlorhydratecombination tablets for the management of <strong>chronic</strong> cancer<strong>pain</strong>: a double-blind comparative trial.[Erratum appears inClin J Pain. 2008 Sep;24(7):649]. Clin J Pain.2008;24(1):1-4. PMID: 18180628. Excluded: inadequateduration.Rodriguez RF, Castillo JM, Castillo MP, et al."Hydrocodone/acetaminophen and tramadol chlorhydratecombination tablets for the management of <strong>chronic</strong> cancer<strong>pain</strong>: a double-blind comparative trial": Correction. Clin JPain. 2008;24(7):649. PMID: 18180628. Excluded: wrongpopulation.Rodriguez RF, Castillo JM, del Pilar Castillo M, et al.Codeine/acetaminophen and hydrocodone/acetaminophencombination tablets for the management of <strong>chronic</strong> cancer<strong>pain</strong> in adults: a 23-day, prospective, double-blind,randomized, parallel-group study. Clin Ther.2007;29(4):581-7. PMID: 17617281. Excluded: inadequateduration.Roelofs PD, Deyo RA, Koes BW, et al. Nonsteroidal antiinflammatorydrugs for low back <strong>pain</strong>: an updatedCochrane review. Spine. 2008;33(16):1766-74. PMID:18580547. Excluded: systematic review or meta-analysisused only as a source document.Roland CL, Setnik B, Cleveland JM, et al. Clinicaloutcomes during <strong>opioid</strong> titration following initiation withor conversion to Remoxy(R), an extended-releaseformulation of oxycodone. Postgrad Med.2011;123(4):148-59. PMID: 21680999. Excluded: wrongstudy design.Rosenblum A, Cruciani RA, Strain EC, et al. Sublingualbuprenorphine/naloxone for <strong>chronic</strong> <strong>pain</strong> in at-risk patients:development and pilot test of a clinical protocol. J OpioidManag. 2012;8(6):369-82. PMID: 23264315. Excluded:wrong study design.Rosenthal M, Moore P, Groves E, et al. Sleep improveswhen patients with <strong>chronic</strong> OA <strong>pain</strong> are managed withmorning dosing of once a day extended-release morphinesulfate (AVINZA): findings from a pilot study. J OpioidManag. 2007;3(3):145-54. PMID: 18027540. Excluded:wrong comparator.Rosti G, Gatti A, Costantini A, et al. Opioid-related boweldysfunction: prevalence and identification of predictivefactors in a large sample of Italian patients on <strong>chronic</strong><strong>treatment</strong>. Eur Rev Med Pharmacol Sci2010;14(12):1045-50. PMID: 21375137. Excluded: wrong comparator.Roth SH, Fleischmann RM, Burch FX, et al. Around-theclock,controlled-release oxycodone therapy forD-21
osteoarthritis-related <strong>pain</strong>: placebo-controlled trial andlong-term evaluation. Arch Intern Med. 2000;160(6):853-60. PMID: 10737286. Excluded: inadequate duration.Rowbotham MC, Reisner-Keller LA, Fields HL. Bothintravenous lidocaine and morphine reduce the <strong>pain</strong> ofpostherpetic neuralgia. Neurology. 1991;41(7):1024-8.PMID: 1712433. Excluded: inadequate duration.Rowbotham MC, Twilling L, Davies PS, et al. Oral <strong>opioid</strong>therapy for <strong>chronic</strong> peripheral and central neuropathic <strong>pain</strong>.N Engl J Med. 2003;348(13):1223-32. PMID: 12660386.Excluded: inadequate duration.Rubinstein AL, Carpenter DM, Minkoff JR. Hypogonadismin men with <strong>chronic</strong> <strong>pain</strong> linked to the use of long-actingrather than short-acting <strong>opioid</strong>s. Clin J Pain. 2013; 29(10):840-5. PMID: 2012423819. Excluded: wrong comparatorRuoff GE, Rosenthal N, Jordan D, et al.Tramadol/acetaminophen combination tablets for the<strong>treatment</strong> of <strong>chronic</strong> lower back <strong>pain</strong>: a multicenter,randomized, double-blind, placebo-controlled outpatientstudy. Clin Ther. 2003;25(4):1123-41. PMID: 12809961.Excluded: inadequate duration.Saadat H, Ziai SA, Ghanemnia M, et al. Opium addictionincreases interleukin 1 receptor antagonist (IL-1Ra) in thecoronary artery disease patients. PLoS ONE.2012;7(9):e44939. PMID: 23028694. Excluded: wrongpopulation.Saarialho-Kere U, Julkunen H, Mattila MJ, et al.Psychomotor performance of patients with rheumatoidarthritis: cross-over comparison of dextropropoxyphene,dextropropoxyphene plus amitriptyline, indomethacin, andplacebo. Pharmacol Toxicol. 1988;63(4):286-92. PMID:3057482. Excluded: wrong intervention.Sabatowski R, Schwalen S, Rettig K, et al. Driving abilityunder long-term <strong>treatment</strong> with transdermal fentanyl. J PainSymptom Manage. 2003;25(1):38-47. PMID: 12565187.Excluded: inadequate duration.Sacchetti G, Camera P, Rossi AP, et al. Injectableketoprofen vs. acetylsalicylic acid for the relief of severecancer <strong>pain</strong>: a double-blind, crossover trial. Drug Intell ClinPharm. 1984;18(5):403-6. PMID: 6373214. Excluded:wrong intervention.Salengros JC, Huybrechts I, Ducart A, et al. Differentanesthetic techniques associated with different incidencesof <strong>chronic</strong> post-thoracotomy <strong>pain</strong>: low-dose remifentanilplus presurgical epidural analgesia is preferable to highdoseremifentanil with postsurgical epidural analgesia. JCardiothorac Vasc Anesth. 2010;24(4):608-16. PMID:20005744. Excluded: wrong intervention.Sanders JC, Gerstein N, Torgeson E, et al. Intrathecalbaclofen for postoperative analgesia after total kneearthroplasty. J Clin Anesth. 2009;21(7):486-92. PMID:20006256. Excluded: wrong intervention.Sandner-Kiesling A, Leyendecker P, Hopp M, et al. Longtermefficacy and safety of combined prolonged-releaseoxycodone and naloxone in the management of non-cancer<strong>chronic</strong> <strong>pain</strong>. Int J Clin Pract. 2010;64(6):763-74. PMID:20370845. Excluded: wrong comparator.Santiago-Palma J, Khojainova N, Kornick C, et al.Intravenous methadone in the management of <strong>chronic</strong>cancer <strong>pain</strong>: safe and effective starting doses whensubstituting methadone for fentanyl. Cancer.2001;92(7):1919-25. PMID: 11745266. Excluded: wrongcomparator.Saper JR, Lake AE, 3rd, Bain PA, et al. A practice guidefor continuous <strong>opioid</strong> therapy for refractory daily headache:patient selection, physician requirements, and <strong>treatment</strong>monitoring. Headache. 2010;50(7):1175-93. PMID:20649650. Excluded: wrong publication type.Sator-Katzenschlager SM, Schiesser AW, Kozek-Langenecker SA, et al. Does <strong>pain</strong> relief improve <strong>pain</strong>behavior and mood in <strong>chronic</strong> <strong>pain</strong> patients? Anesth Analg.2003;97(3):791-7. PMID: 12933404. Excluded: wrongcomparator.Saunders KW, Von Korff M, Campbell CI, et al.Concurrent use of alcohol and sedatives among personsprescribed <strong>chronic</strong> <strong>opioid</strong> therapy: prevalence and riskfactors. J Pain. 2012;13(3):266-75. PMID: 22285611.Excluded: wrong study design.Sawe J, Hansen J, Ginman C, et al. Patient-controlled doseregimen of methadone for <strong>chronic</strong> cancer <strong>pain</strong>. Br Med J.1981;282(6266):771-3. PMID: 6163497. Excluded:inadequate duration.Saxon AJ, Wells EA, Fleming C, et al. Pre-<strong>treatment</strong>characteristics, program philosophy and level of ancillaryservices as predictors of methadone maintenance <strong>treatment</strong>outcome. Addiction. 1996;91(8):1197-209. PMID:8828247. Excluded: wrong population.Saxon AJ, Ling W, Hillhouse M, et al.Buprenorphine/naloxone and methadone effects onlaboratory indices of liver health: A randomized trial. DrugAlcohol Depend. 2013; 128(1-2): 71-6. PMID: 22921476.Excluded: wrong populationSchackman BR, Leff JA, Polsky D, et al. Costeffectivenessof long-term outpatient buprenorphinenaloxone<strong>treatment</strong> for <strong>opioid</strong> dependence in primary care.J Gen Intern Med. 2012;27(6):669-76. PMID: 22215271.Excluded: wrong study design.Schein JR, Kosinski MR, Janagap-Benson C, et al.Functionality and health-status benefits associated withreduction of osteoarthritis <strong>pain</strong>. Curr Med Res Opin2008;24(5):1255-65. PMID: 18358082. Excluded: wrongintervention.Scher A, Lipton R, Stewart W, et al. Patterns of medicationuse by <strong>chronic</strong> and episodic headache sufferers in theD-22
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Evidence Report/Technology Assessme
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PrefaceThe Agency for Healthcare Re
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Charles Inturrisi, Ph.D.Professor o
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Robert Jamison, Ph.D.Professor of A
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Conclusions. Evidence on long-term
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no opioid on: (1) opioid abuse, add
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References ........................
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The purpose of this report is to sy
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patient education, (3) urine drug s
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Each abstract was independently rev
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We rated the quality of each cohort
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ResultsOverviewThe search and selec
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Key Question 4. Risk Assessment and
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Table A. Summary of evidence (conti
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Table A. Summary of evidence (conti
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Table A. Summary of evidence (conti
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Evidence on the effectiveness of di
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ApplicabilityA number of issues cou
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the exception of buccal or intranas
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References1. International Associat
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outcome study of long-term opioid d
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patients? Pain Physician. 2006;9(1)
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American Academy of Pain Medicine,
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d. What is the comparative effectiv
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inclusion to English-language artic
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adequately reported and acceptable;
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eview comments will be made availab
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Key Question 1aIn patients with chr
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Key Question 2aIn patients with chr
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and F2). 49-58 All were rated fair-
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Table 1. Uncontrolled studies of lo
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Table 1. Uncontrolled studies of lo
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The annual overdose rate was 256 pe
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The SOE for the association between
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One fair-quality cross-sectional st
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5300 controls who did not visit the
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Key Question 3cIn patients with chr
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Table 2. Head-to-head trials and ob
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Table 2. Head-to-head trials and ob
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withdrawal due to opioid misuse, bu
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Table 3. Trials of different strate
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Table 3. Trials of different strate
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• Two studies evaluated the Scree
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Table 4. Studies of risk assessment
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Detailed SynthesisThe APS review id
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Evidence on the effectiveness of di
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Table 6. Summary of evidence (conti
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Table 6. Summary of evidence (conti
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- Page 137 and 138: Gianutsos L, Safrenek S. Is there a
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Author yearStudy designDurationCowa
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Author YearRalphs, 1994StudyDesignD
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Author,Year Study DesignAkbik 2006
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Author,YearWebster2005Study DesignP
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Appendix F. Quality Assessment Tabl
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Author,YearGomes,2011Gomes,2013KQKQ
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Evaluatespopulationother than theon
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Key QuestionOutcomeStudy DesignNumb
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Key QuestionOutcomeStudy DesignNumb
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Key Question Outcome4. Risk assessm
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