Razones clínicas de elección de hidromorfona OROS? para el tratamiento de pacientes con dolor crónico no oncológico: Estudio HIDOCO

摘要

Objective: to establish the clinical reasons for prescribing OROS? hydromorphone in patients with chronic non-cancer pain. Material and methods: an observational, retrospective, multicenter, Spanish study in patients with chronic non-cancer pain treated with OROS? hydromorphone between 1 and 5 months. The recorded information stemmed from the medical records of the patient, from the information given by the investigator of its clinical daily practice and from two questionnaires administered to the patient on adherence (Morisky-Green) and quality of life (SF-36). Results: 53 investigators included data of 438 patients with a mean age of 62 years, 43.4% of them under 60 years of age. The most prevalent pathological conditions were osteoarthritis and low-back pain. Despite the time from the onset of the pain was 6.4 years, 23.3% of the patients had been experiencing pain over 10 years. Before starting treatment with OROS? hydromorphone, 62% had VAS score >7 and 33.5% had VAS score 5-7. The combination of minor opioids and NSAIDs was the most common previous treatment, and only 5% were receiving strong opioids alone. The main reason for starting OROS? hydromorphone was the lack of efficacy with the previous opioid (62.1%), and the first criterion for the choice was efficacy (81.7%), followed by dosage (60.3%) and tolerability profile (47.7%). 93.4% of the patients stated that they regularly took their medicine at the right time and 57.8% considered that their current health condition was better or unchanged from the previous year. Conclusions: Undertreated pain and the lack of use of strong opioids in patients with chronic non-cancer pain are still important issues. OROS? Hydromorphone is a valid therapeutic option, with its efficacy, dosage and tolerability profile as the main reasons for its choice.