Petter C Borchgrevink

Norwegian University of Science and Technology, Nidaros, Sør-Trøndelag, Norway

Are you Petter C Borchgrevink?

Claim your profile

Publications (111)235.89 Total impact

  • Stephen Butler · Tormod Landmark · Mari Glette · Petter Borchgrevink · Astrid Woodhouse ·

    Pain 11/2015; DOI:10.1097/j.pain.0000000000000417 · 5.21 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The aim of this study was to identify symptoms associated with subjective memory complaints (SMCs) among subjects who are currently on sick leave due to symptoms of chronic pain, fatigue, depression, anxiety, and insomnia. Methods: This was a cross-sectional study, subjects (n = 167) who were currently on sick leave were asked to complete an extensive survey consisting of the following: items addressing their sociodemographics, one item from the SF-8 health survey measuring pain, Chalder Fatigue Questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and Everyday Memory Questionnaire - Revised. General linear modeling was used to analyze variables associated with SMCs. Results: Symptoms of fatigue (p-value < 0.001) and anxiety (p-value = 0.001) were uniquely and significantly associated with perceived memory failures. The associations with symptoms of pain, depression, and insomnia were not statistically significant. Conclusions: Subjective memory complaints should be recognized as part of the complex symptomatology among patients who report multiple symptoms, especially in cases of fatigue and anxiety. Self-report questionnaires measuring perceived memory failures may be a quick and easy way to incorporate and extend this knowledge into clinical practice.
    Frontiers in Psychology 10/2015; 6:1338. DOI:10.3389/fpsyg.2015.01338 · 2.80 Impact Factor
  • A Mellbye · Ø Karlstad · S Skurtveit · P C Borchgrevink · O M S Fredheim ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Prescription databases provide the opportunity for investigating opioid treatment and co-medication within large populations. So far, few studies have investigated the duration of opioid therapy, and large differences in discontinuation rates have been reported. Data from the Norwegian Prescription Database were used to follow the study population of all adult persistent opioid users with non-malignant pain in Norway in 2005 (n = 44,867) for 6 years. Persistent opioid use was defined as being dispensed ≥ 180 defined daily doses (DDD) or 4500 mg oral morphine equivalents (OMEQ) during a 365-day period. The study population was stratified according to previous opioid use into new persistent opioid users, without previous persistent opioid use, and previous low-dose or previous high-dose persistent opioid users, having earlier persistent opioid use and received less or more than 120 mg OMEQ/day in 2005, respectively. Twenty-seven percent of new, 59% of previous low-dose, and 55% of previous high-dose users met the criteria of persistent use of opioids each year. Exactly, 22%, 11%, and 3% increased their cumulative yearly opioid dose by 200% or more during the study period. With 80% still being regular users of either drugs, 6 years later, long-term persistent opioid users were more likely to continue concomitant use of benzodiazepines or z-hypnotics than other users, CONCLUSION: The findings confirm high discontinuation rates in patients receiving opioids for chronic non-malignant pain. However, a clinically significant number of patients increase their doses over 6 years and many patients combine long-term opioid treatment with benzodiazepines and z-hypnotics. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
    Acta Anaesthesiologica Scandinavica 08/2015; DOI:10.1111/aas.12594 · 2.32 Impact Factor
  • Source
    Nicolas-Andreas L Elvemo · Nils Inge Landrø · Petter C Borchgrevink · Asta K Håberg ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Patients with chronic pain (CP) are often reported to have deficits in working memory. Pain impairs working memory, but so do depression and sleep problems, which are also common in CP. Depression has been linked to changes in brain activity in CP during working memory tasks, but the effect of sleep problems on working memory performance and brain activity remains to be investigated. Methods: Fifteen CP patients and 17 age-, sex-, and education-matched controls underwent blood-oxygen-level dependent (BOLD) functional magnetic resonance imaging at 3T while performing block design 0-back, 2-back, and paced visual serial addition test paradigms. Subjects also reported their level of pain (Brief Pain Inventory), depression (Beck Depression Inventory II), and sleep problems (Pittsburgh Sleep Quality Index) and were tested outside the scanner with neuropsychological tests of working memory. Results: The CP group reported significantly higher levels of pain, depression, and sleep problems. No significant performance difference was found on the neuropsychological tests in or outside the scanner between the two groups. There were no correlations between level of pain, depression, and sleep problems or between these and the neuropsychological test scores. CP patients exhibited significantly less brain activation and deactivation than controls in parietal and frontal lobes, which are the brain areas that normally show activation and deactivation during working memory tasks. Sleep problems independently and significantly modulated the BOLD response to the complex working memory tasks and were associated with decreased brain activation in task-positive regions and decreased deactivation in the default mode network in the CP group compared to the control group. The pain and depression scores covaried with working memory activation. Discussion: Sleep problems in CP patients had a significant impact on the BOLD response during working memory tasks, independent of pain level and depression, even when performance was shown not to be significantly affected.
    Journal of Pain Research 07/2015; 8:335–346. DOI:10.2147/JPR.S83486
  • A B Hansen · S Skurtveit · P C Borchgrevink · O Dale · P R Romundstad · M Mahic · O M Fredheim ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Although persons with chronic pain are frequent users of the health care system, they report poor satisfaction with health care services. Participants with persistent opioid use in Nord-Trøndelag Health Study (HUNT)3 report severe pain in spite of treatment. The aim of the study was to test the hypothesis that subjects with persistent opioid use have both a higher consumption of health care services and a poorer satisfaction than the remaining subjects reporting chronic pain. This cross-sectional study was based on linkage of self-reported data from the substudy (10,238 were invited, 6927 met the inclusion criteria) of health care use in HUNT3; a population-based health survey during the years 2006-2008 and the complete national registers of the Norwegian Prescription Database and the Cancer Registry of Norway. Patients with chronic pain are stratified according to the level of opioid use as persistent users of opioids, intermittent users, and persons not using opioids. Persons with chronic non-malignant pain reported a higher consumption of all health care services compared to the control group. Consumption of health care services increased with increasing level of opioid use. Persons with persistent opioid use were highly satisfied with all health care services, although less satisfied than persons without chronic pain. Combined with previous findings of high levels of pain in spite of opioid treatment, the present findings indicate that symptomatic relief is not a prerequisite for patient satisfaction. The study shows higher patient satisfaction compared to previous studies. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
    Acta Anaesthesiologica Scandinavica 06/2015; 59(10). DOI:10.1111/aas.12568 · 2.32 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There are concerns about potential increasing use of over-the-counter (OTC) analgesics. The aims of this study were to examine 1) the prevalence of self-reported use of OTC analgesics; 2) the prevalence of combining prescription analgesics drugs with OTC analgesics and 3) whether lifestyle factors such as physical activity were associated with prevalence of daily OTC analgesic use. Questionnaire data from the Nord-Trøndelag health study (HUNT3, 2006-08), which includes data from 40,000 adult respondents. The questionnaire included questions on use of OTC analgesics, socioeconomic conditions, health related behaviour, symptoms and diseases. Data were linked to individual data from the Norwegian Prescription Database. A logistic regression was used to investigate the association between different factors and daily use of paracetamol and/or non-steroid anti-inflammatory drugs (NSAIDs) in patients with and without chronic pain. The prevalence of using OTC analgesics at least once per week in the last month was 47%. Prevalence of paracetamol use was almost 40%, compared to 19% and 8% for NSAIDs and acetylsalicylic acid (ASA), respectively. While the use of NSAIDs decreased and the use of ASA increased with age, paracetamol consumption was unaffected by age. Overall more women used OTC analgesics. About 3-5% of subjects using OTC analgesics appeared to combine these with the same analgesic on prescription. Among subjects reporting chronic pain the prevalence of OTC analgesic use was almost twice as high as among subjects without chronic pain. Subjects with little physical activity had 1.5-4 times greater risk of daily use of OTC compared to physically active subjects. Use of OTC analgesics is prevalent, related to chronic pain, female gender and physical inactivity.
    BMC Public Health 05/2015; 15(1):461. DOI:10.1186/s12889-015-1774-6 · 2.26 Impact Factor
  • Source
    N.A. Elvemo · N I Landrø · P C Borchgrevink · A.K. Håberg ·
    [Show abstract] [Hide abstract]
    ABSTRACT: It is proposed that changes in reward processing in the brain are involved in the pathophysiology of pain based on experimental studies. The first aim of the present study was to investigate if reward drive and/or reward responsiveness was altered in patients with chronic pain (PCP) compared to controls matched for education, age and sex. The second aim was to investigate the relationship between reward processing and nucleus accumbens volume in PCP and controls. Nucleus accumbens is central in reward processing and its structure has been shown to be affected by chronic pain conditions in previous studies. Reward drive and responsiveness were assessed with the Behavioral Inhibition Scale/Behavioral Activation Scale, and nucleus accumbens volumes obtained from T1-weighted brain MRIs obtained at 3T in 19 PCP of heterogeneous aetiologies and 20 age-, sex- and education-matched healthy controls. Anhedonia was assessed with Beck's Depression Inventory II. The PCP group had significantly reduced scores on the reward responsiveness, but not reward drive. There was a trend towards smaller nucleus accumbens volume in the PCP compared to control group. There was a significant positive partial correlation between reward responsiveness and nucleus accumbens volume in the PCP group adjusted for anhedonia, which was significantly different from the same relationship in the control group. Reward responsiveness is reduced in chronic pain patients of heterogeneous aetiology, and this reduction was associated with nucleus accumbens volume. Reduced reward responsiveness could be a marker of chronic pain vulnerability, and may indicate reduced opioid function. © 2015 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.
    European journal of pain (London, England) 03/2015; 19(10). DOI:10.1002/ejp.687 · 2.93 Impact Factor
  • Olav Magnus S Fredheim · Milada Mahic · Svetlana Skurtveit · Petter C Borchgrevink ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Breakthrough pain affects 40%-90% of patients with cancer pain. Nasal fentanyl is one of the recommended treatments, particularly if the breakthrough pain is of rapid onset. To investigate the prevalence of use of nasal fentanyl, to study which strong opioids have been used prior to nasal fentanyl and to examine which opioids are used concomitantly with nasal fentanyl. Longitudinal cohort study based on death cohorts defined according to year of death. The study is based on data from the complete national Norwegian Prescription Database. The study population included all persons in Norway who died in the years 2010, 2011 and 2012 and who had received nasal fentanyl with reimbursement for palliative treatment. Of those who died from cancer in 2010, 2011 and 2012, 611 persons (2%) received dispensed prescriptions of nasal fentanyl. Two-thirds had received other short-acting strong opioids before nasal fentanyl. One quarter did not receive a long-acting opioid concomitantly with nasal fentanyl, but 68% of these received only one dispensed prescription of nasal fentanyl. Of those who received a long-acting opioid together with nasal fentanyl, transdermal fentanyl was the most common drug (65%). One-third received another short-acting opioid concomitantly with nasal fentanyl. The use of nasal fentanyl was surprisingly low. There is a need for clinical research addressing the use of nasal fentanyl without a long-acting opioid for background pain and the use of nasal fentanyl together with another short-acting opioid. © The Author(s) 2015.
    Palliative Medicine 03/2015; 29(7). DOI:10.1177/0269216315575252 · 2.86 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The definition of Chronic Fatigue Syndrome (CFS) overlaps with definitions of insomnia, but there is limited knowledge about the role of insomnia in the treatment of chronic fatigue. To test if improvement of insomnia during treatment of chronic fatigue was associated with improved outcomes on 1) fatigue and 2) cortisol recovery span during a standardized stress exposure. Patients (n=122) with chronic fatigue received a 3.5-week inpatient return-to-work rehabilitation program based on Acceptance and Commitment Therapy, and had been on paid sick leave>8weeks due their condition. A physician and a psychologist examined the patients, assessed medication use, and SCID-I diagnoses. Patients completed self-report questionnaires measuring fatigue, pain, depression, anxiety, and insomnia before and after treatment. A subgroup (n=25) also completed the Trier Social Stress Test for Groups (TSST-G) before and after treatment. Seven cortisol samples were collected during each test and cortisol spans for the TSST-G were calculated. A hierarchical regression analysis in nine steps showed that insomnia improvement predicted improvement in fatigue, independently of age, gender, improvement in pain intensity, depression and anxiety. A second hierarchical regression analysis showed that improvement in insomnia significantly predicted the cortisol recovery span after the TSST-G independently of improvement in fatigue. Improvement in insomnia severity had a significant impact on both improvement in fatigue and the ability to recover from a stressful situation. Insomnia severity may be a maintaining factor in chronic fatigue and specifically targeting this in treatment could increase treatment response. Copyright © 2014. Published by Elsevier Inc.
    Journal of Psychosomatic Research 12/2014; 78(5). DOI:10.1016/j.jpsychores.2014.11.022 · 2.74 Impact Factor
  • M. Mahic · O.M. Fredheim · P.C. Borchgrevink · S. Skurtveit ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Background There are few studies on the use of opioids among children and adolescents. The aim of this study was to determine the 1-year prevalence of prescribed opioid dispensing in Denmark, Norway and Sweden, and to compare gender and age differences in the use of weak and strong opioids between the three countries.Methods Data on the dispensing of opioids were collected from the websites of the complete national prescription databases in the three countries. All individuals aged 0–19 with at least one prescription of opioids during the study period were included.ResultsThe 1-year prevalence of opioid use among young individuals aged 0–19 years increased during the study period (2006–2012) in Denmark from 2.5 to 3.4 per thousand, in Norway from 10.7 to 13.4 per thousand and in Sweden from 5.9 to 7.1 per thousand. In all three countries, more boys than girls used opioids between the ages of 0 and 10, whereas girls were the major users in the age range 11–19. Use of opioids in all three countries was dominated by weak opioids, codeine being the most dominant in Norway and Sweden and tramadol in Denmark.Conclusions The 1-year prevalence of prescribed opioid use among children and adolescents in Norway was far higher than in Denmark and Sweden. During the study period, an increasing use of opioids among children and adolescents was observed in all three countries.
    European journal of pain (London, England) 12/2014; 19(8). DOI:10.1002/ejp.632 · 2.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: This study aimed to describe the somatic, social, psychological, and work-related factors that characterize participants with a duration of sick leave over and under one year. Methods: During 2012, 181 patients on long-term sick leave were consecutively recruited and asked to answer an extensive survey. Several outcomes were reported, addressing work-related factors and somatic, psychological, and social symptoms. In cross-sectional analyses, sick leave duration was dichotomized as > or < one year, based on Norwegian legislation. Linear and logistic regressions were used to estimate population probabilities and means. Results: The estimated prevalence of pain, fatigue, anxiety, and depression was overall high. There was a tendency towards a higher prevalence of fatigue, anxiety, and depression in those with sick leave duration less than one year, with the exception of sleep problems, which was more frequent in the population with longer duration. Relationship with friends, family, co-workers, and the last workplace were worse in the population with longer duration. Conclusions: Cross-sectional analyses indicated that social and work-related problems are more adverse in patients with longer duration of sick leave, while psychological and somatic symptoms appear less adverse. This is one of the first studies quantitatively demonstrating these differences through comprehensive, simultaneously measured self-report questionnaires.
    Scandinavian Journal of Occupational Therapy 10/2014; 22(1):1-9. DOI:10.3109/11038128.2014.957241 · 1.09 Impact Factor
  • A Mellbye · O Karlstad · S Skurtveit · P C Borchgrevink · O M S Fredheim ·
    [Show abstract] [Hide abstract]
    ABSTRACT: In patients with chronic non-malignant pain (CNMP), co-morbid physical or mental health disorders are common and may have a negative impact on health-related quality of life and treatment outcomes. The purpose of this study was to examine the occurrence of chronic psychiatric and somatic diseases in persistent opioid users with CNMP compared with the general population in Norway. In this cross-sectional study, prescription patterns of dispensed opioids were used to identify a study population of persistent opioid users with CNMP from the general population. Reimbursed prescriptions marked with diagnostic codes were used to identify the occurrence of 21 somatic and 3 psychiatric diseases for a 1-year period in the Norwegian Prescription Database. Occurrence of disease in persistent opioid users was compared to an age- and gender-specific population of all Norwegian residents aged 18-79 years in 2009. Standardized morbidity ratios (SMRs) for each disease were calculated. Eighty-five percent of the persistent opioid user population had at least one co-morbid disease compared with 45% of the general population. Forty-two percent had three or more co-morbidities. SMRs in both men and women were generally increased except for dementia, glaucoma and renal disease, indicating a higher occurrence of disease in persistent opioid users. A higher occurrence of both somatic and psychiatric co-morbidities in disease stages warranting pharmacological treatment was found in persistent opioid users with CNMP compared with the general population of Norway.
    European journal of pain (London, England) 09/2014; 18(8). DOI:10.1002/j.1532-2149.2014.00449.x · 2.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients with chronic pain have impaired cognitive functions, including decision making, as shown with the Iowa gambling task (IGT). The main aim of this study was to elucidate whether patients' decision making is associated with a lack of the anticipatory skin conductance response (SCR). An increase in anticipatory SCR before making unfavorable choices is known to guide decisions in healthy controls during the IGT. Since several brain regions involved in decision making are reported to have altered morphology in patients with chronic pain, the second aim was to explore the associations between IGT performance and brain structure volumes. Eighteen patients with chronic pain of mixed etiology and 19 healthy controls matched in terms of age, sex, and education were investigated with a computerized IGT during the recording of SCR, heart rate, and blood pressure. The participants also underwent neuropsychological testing, and three-dimensional T1-weighted cerebral magnetic resonance images were obtained. Contrary to controls, patients did not generate anticipatory SCRs before making unfavorable choices, and they switched between decks of cards during the late phase of the IGT significantly more often, and this was still observed after adjusting for depression scores. None of the other autonomic measures differed during IGT performance in either group or between groups. In patients, IGT scores correlated positively with total cortical grey matter volume. In controls, there was no such association, but their IGT scores correlated with the anticipatory SCR. It may be speculated that the reduction in anticipatory SCRs makes the chronic pain patients rely more on cortical resources during decision making.
    Journal of Pain Research 07/2014; 7:425-37. DOI:10.2147/JPR.S62492
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to (1) See whether increased or decreased variation relate to subjective reports of common somatic and psychological symptoms for a population on long-term sick leave; and (2) See if this pattern in variation is correlated with autonomic activation and psychological appraisal. Our participants (n = 87) were referred to a 3.5-week return-to-work rehabilitation program, and had been on paid sick leave >8 weeks due to musculoskeletal pain, fatigue and/or common mental disorders. An extensive survey was completed, addressing socio-demographics, somatic and psychological complaints. In addition, a physician and a psychologist examined the participants, determining baseline heart rate, medication use and SCID-I diagnoses. During the 3.5-week program, the participants completed the Trier Social Stress Test for Groups. Participants wore heart rate monitors and filled out Visual Analogue Scales during the TSST-G. Our participants presented a low cortisol variation, with mixed model analyses showing a maximal increase in free saliva cortisol of 26% (95% CI, 0.21-0.32). Simultaneously, the increase in heart rate and Visual Analogue Scales was substantial, indicating autonomic and psychological activation consistent with intense stress from the Trier Social Stress Test for Groups. The current findings are the first description of a blunted cortisol response in a heterogeneous group of patients on long-term sick leave. The results suggest lack of cortisol reactivity as a possible biological link involved in the pathway between stress, sustained activation and long-term sick leave.
    PLoS ONE 05/2014; 9(5):e96048. DOI:10.1371/journal.pone.0096048 · 3.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BackgroundLong-term sick leave has considerably negative impact on the individual and society. Hence, the need to identify effective occupational rehabilitation programs is pressing. In Norway, group based occupational rehabilitation programs merging patients with different diagnoses have existed for many years, but no rigorous evaluation has been performed. The described randomized controlled trial aims primarily to compare two structured multicomponent inpatient rehabilitation programs, differing in length and content, with a comparative cognitive intervention. Secondarily the two inpatient programs will be compared with each other, and with a usual care reference group.Methods/designThe study is designed as a randomized controlled trial with parallel groups. The Social Security Office performs monthly extractions of sick listed individuals aged 18–60 years, on sick leave 2–12 months, with sick leave status 50% - 100% due to musculoskeletal, mental or unspecific disorders. Sick-listed persons are randomized twice: 1) to receive one of two invitations to participate in the study or not receive an invitation, where the latter “untouched” control group will be monitored for future sick leave in the National Social Security Register, and 2) after inclusion, to a Long or Short inpatient multicomponent rehabilitation program (depending on which invitation was sent) or an outpatient cognitive behavioral therapy group comparative program. The Long program consists of 3 ½ weeks with full rehabilitation days. The Short program consists of 4 + 4 full days, separated by two weeks, in which a workplace visit will be performed if desirable. Three areas of rehabilitation are targeted: mental training, physical training and work-related problem solving. The primary outcome is number of sick leave days. Secondary outcomes include time until full sustainable return to work, health related quality of life, health related behavior, functional status, somatic and mental health, and perceptions of work. In addition, health economic evaluation will be performed, and the implementation of the interventions, expectations and experiences of users and service providers will be investigated with different qualitative methods.Trial NCT01926574.
    BMC Public Health 04/2014; 14(1):368. DOI:10.1186/1471-2458-14-368 · 2.26 Impact Factor
  • L Pedersen · P C Borchgrevink · I I Riphagen · O M S Fredheim ·
    [Show abstract] [Hide abstract]
    ABSTRACT: In selected patients with chronic non-malignant pain, chronic opioid therapy is indicated. Published guidelines recommend long-acting over short-acting opioids in these patients. The aim of this systematic review was to investigate whether long-acting opioids in chronic non-malignant pain are superior to short-acting opioids in pain relief, physical function, sleep quality, quality of life or adverse events. This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for relevant trials up to July 2012. Reference lists of included trials and relevant reviews were in addition searched by hand. Of the 1168 identified publications, 6 randomised trials evaluating efficacy and safety filled the criteria for inclusion. None of them found a significantly better pain relief, significantly less consumption of rescue analgesia, improved quality of sleep or improved physical function from long-acting opioids. None of the trials investigated quality of life. None of the trials investigated adverse events properly nor addiction, tolerance or hyperalgesia. Three trials in healthy volunteers with a recreational drug use, found no difference in abuse potential between long- and short-acting opioids. While long term, comparative data are lacking, there is fair evidence from short-term trials that long-acting opioids provide equal pain relief compared with short-acting opioids. Contrary to several guidelines, there is no evidence supporting long-acting opioids superiority to short-acting ones in improving functional outcomes, reducing side effects or addiction.
    Acta Anaesthesiologica Scandinavica 04/2014; 58(4):390-401. DOI:10.1111/aas.12279 · 2.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In previous studies on prescription patterns of opioids accurate data on pain are missing, and previous epidemiological studies of pain lack accurate data on opioid use. The present linkage study which investigates the relationship between pain and opioid use is based on accurate individual data from the complete national Norwegian prescription database and the Nord-Trøndelag health study 3 which includes about 46 000 persons. Baseline data were collected in 2006 to 2008 and the cohort was followed for three years. Of 14 477 persons who reported chronic non-malignant pain 85% did not use opioids at all, while 3% used opioids persistently and 12% occasionally. Even in the group reporting severe or very severe chronic pain the number not using opioids (2680) was far higher than the number who used opioids persistently (304). However, three quarters of persons using opioids persistently reported strong or very strong pain in spite of the medication. Risk factors for persons with chronic pain who were not persistent opioid users at baseline, to use opioids persistently three years later were occasional use of opioids, prescription of >100 defined daily doses/year of benzodiazepines, physical inactivity, reports of "strong" pain intensity, and prescription of drugs from eight or more ATC groups. The study demonstrated that most persons having chronic non-malignant pain are not using opioids, even if the pain is strong or very strong. However, the vast majority of patients with persistent opioid use report strong or very strong pain in spite of opioid treatment.
    Pain 03/2014; 155(7). DOI:10.1016/j.pain.2014.03.009 · 5.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BackgroundA growing proportion of the population is using opioids for longer time periods, but little is known about the characteristics of patients who are persistent opioid users. We therefore studied the association between socio-economic factors and persistent vs. short-term opioid use 4 years later. Methods The background population is the complete Norwegian population in 2001. The study population is derived from two groups aged 35 years or older in 2001 who met one of the following criteria in 2005: (1) persistent opioid users (n = 15,113) or (2) short-term opioid users (n = 214,061). The applied definition of persistent opioid use corresponds to an average daily dose indicating likely daily use of opioids during 365 consecutive days. The socio-economic factors work status, income, marital status, immigrant status and education were obtained from the Population and Housing Census of 2001, and data on opioid use in 2005 were obtained from the complete national Norwegian Prescription Database. For logistic regression analyses, the study population was stratified by gender and by age over/under 67 years. ResultsIn the 35- to 67-year-old age group, receiving a disability pension was more common in persistent opioid users compared with short-term opioid users (48% vs. 16% for women, 36% vs. 9% for men). Adjusted odds ratios for receiving a disability pension were 6.51 and 5.77 for women and men, respectively. Being divorced/separated was associated with being a persistent opioid user (odds ratio of 1.4 for both genders). There were also negative associations between persistent opioid use and attained education level, an unemployed working status and income status. Conclusion Disability pension, not working, divorce, low income and low education in 2001 were associated with persistent opioid use in 2005.
    Acta Anaesthesiologica Scandinavica 03/2014; DOI:10.1111/aas.12281 · 2.32 Impact Factor
  • EA Fors · HB Jacobsen · PC Borchgrevink · TC Stiles ·

  • Line Pedersen · Petter Christian Borchgrevink · Harald Petter Breivik · Olav Magnus Søndenå Fredheim ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Guidelines for opioid treatment of chronic non-malignant pain recommend long-acting over short-acting opioid formulations. The evidence for this recommendation is weak. This study is a randomized, double blind, double dummy, 8-week comparison of long-acting dihydrocodeine tablets (DHC-Continus®) with short-acting dihydrocodeine tablets in 60 chronic non-malignant pain patients referred to a multidisciplinary pain clinic. All patients used codeine-paracetamol tablets before the trial and paracetamol was added in both groups during the trial. The primary outcome was stability in pain intensity, measured as the difference between the highest and least pain intensity reported on an 11-point numerical rating scale in a 7-day diary. The secondary outcomes were differences in quality of life, quality of sleep, depression and episodes of breakthrough pain between the two formulations. Spontaneously reported adverse events were recorded. Thirty-eight patients completed, 22 withdrew before the end of the trial. The reasons were adverse events, lack of efficacy, or both and were similar between the groups. There were no significant differences in stability of pain intensity between groups. There were no significant differences between groups in quality of sleep, depression, health-related quality of life or adverse events. Breakthrough pain was experienced in both groups during the trial. Long-acting dihydrocodeine was not superior for any of the outcomes in this trial. This study does not support current guidelines recommending long-acting opioids.
    Pain 12/2013; 155(5). DOI:10.1016/j.pain.2013.12.016 · 5.21 Impact Factor

Publication Stats

2k Citations
235.89 Total Impact Points


  • 2000-2015
    • Norwegian University of Science and Technology
      • • Department of Circulation and Medical Imaging
      • • Faculty of Medicine
      Nidaros, Sør-Trøndelag, Norway
  • 2004-2012
    • St. Olavs Hospital
      • Department for Pain and Complex Disorders
      Nidaros, Sør-Trøndelag, Norway
  • 2010
    • Sykehuset Telemark
      Skien, Telemark, Norway
  • 2009
    • NTNU Samfunnsforskning
      Nidaros, Sør-Trøndelag, Norway
  • 2008
    • University Hospital of North Norway
      • Department of Anesthesia
      Tromsø, Troms, Norway