Photo Credit: iStock.com/simon2579

Inadequate chronic pain care under long-term opioid therapy highlights the need for better Chronic Care Model integration in outpatient settings.

A study published in the June 2025 issue of BMC Primary Care on the clinical complexity of managing chronic non-cancer pain (CNCP) in outpatient settings, where long-term opioid therapy, though indicated for selected individuals, carried significant risks, necessitating structured, guideline-based care.  

Researchers examined the association between healthcare quality based on the Chronic Care Model (CCM) and individual or healthcare-related factors in those receiving long-term opioid therapy for chronic back and/or arthrosis pain.  

They performed a cross-sectional patient survey targeting a random sample of 3,037 individuals with chronic arthrosis and/or back pain receiving long-term opioid therapy, all insured by a major German statutory health insurance (SHI) provider. Healthcare quality based on the CCM was evaluated using the Patient Assessment of Chronic Illness Care (PACIC-5A) questionnaire. Internal reliability was assessed using Cronbach’s α. Descriptive statistics were used for outcome scales, and subgroup analyses were performed based on individual characteristics, health status, and pain management variables. Statistical significance was tested using the Mann-Whitney U test and Kruskal-Wallis test, and effect sizes were calculated using Eta and Spearman’s Rank correlation coefficient.  

The results showed that 661 individuals were included, with 76% being female and a mean age of 69 years (standard deviation [SD] 12.5). The PACIC-5A scores were low across all subscales, with a summary score of 2.4 on a 1–5 scale (1 = worst, 5 = best). Subgroup analysis indicated positive associations between higher PACIC-5A scores and guideline-adherent treatment aspects, such as defined therapy goals and comprehensive care approaches. Minimal correlations were found with patient characteristics, except for a positive link between higher PACIC-5A scores and both younger age and higher education. No consistent correlation was observed between pain intensity or impairment and PACIC-5A scores.  

Investigators concluded that healthcare quality for individuals receiving long-term opioid therapy for CNCP was suboptimal and positively associated with adherence to guideline-based treatment within the CCM framework. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02881-3