Time-scheduled vs. XXXX -contingent opioid dosing in @entity4784 .

@entity1 @entity4784 @entity1286 @entity158
Some expert guidelines recommend time-scheduled opioid dosing over @entity158 -contingent dosing for @entity1 receiving @entity4784 ( @entity4784 ). The premise is that time-scheduled dosing results in more stable opioid blood levels and @entity158 relief, fewer adverse effects, less reinforcement of @entity158 , and lower addiction risk. We report results of a survey of 1781 @entity1 receiving @entity4784 for chronic @entity158 , in which 967 reported time-scheduled opioid dosing only and 325 reported @entity158 -contingent opioid dosing only. Opioid-related problems and concerns were assessed with the Prescribed Opioids Difficulties Scale. We hypothesized that respondents using time-scheduled opioid dosing would report significantly fewer problems and concerns than those using @entity158 -contingent dosing. @entity1 receiving time-scheduled dosing received substantially higher average daily opioid doses than those using @entity158 -contingent dosing (97.2 vs. 37.2mg average daily dose @entity1286 equivalents, P < .0001). Contrary to expectation, time-scheduled opioid dosing was associated with higher levels of @entity1 opioid control concerns than @entity158 -contingent dosing (6.2 vs. 4.8, P=.008), after adjusting for @entity1 and drug regimen differences. Opioid-related psychosocial problems were somewhat greater among @entity1 using time-scheduled dosing, but this difference was nonsignificant after controlling for @entity1 and drug regimen differences (5.9 vs. 5.0, P=.14). Time-scheduled dosing typically involved higher dosage levels and was associated with higher levels of @entity1 concerns about opioid use. Controlled comparative effectiveness research is needed to assess benefits and risks of time-scheduled opioid dosing relative to @entity158 -contingent opioid dosing among @entity4784 @entity1 in ambulatory care. @entity1 with time-scheduled dosing received higher opioid dosage than @entity1 with @entity158 -contingent dosing. Time-scheduled dosing was associated with greater opioid control concerns than @entity158 -contingent dosing.
