Abstract:
Objective:
This systematic review aimed to determine the analgesic efficacy and safety of transdermal fentanyl patch as compared to other opioid therapy or placebo in pain management among the patients from different medical condition.
Methods:
30 studies (22 randomised controlled trials and eight observational studies) were included for data synthesis, after searching and screening through PubMed, Excerpta Medica database (Embase), International Pharmaceutical Abstracts (IPA), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Turning Research into Practice (TRiP) databases. Two authors independently screened the articles and assessed the quality of the studies. SIGN checklist and Cochrane Collaboration’s tool were applied to assess the risk of bias in observational and randomized controlled studies. Data on study background, interventions, outcomes measured and outcomes were synthesized into table forms.
Results:
Pain scores, adverse events and addiction risks were the primary outcomes in this systematic review. Transdermal fentanyl patch showed significant improvement in terms of pain scores when compared to placebo. When fentanyl patch was compared
to other opioid treatment, the results were mostly comparable. In terms of adverse events, fentanyl patch and opioid treatment shared similar incidence adverse events with no significant difference.
Conclusions:
Transdermal fentanyl patch improved pain scores significantly compared to placebo while the opioid efficacy and safety were similar when compared with other opioid therapies. Other than that, the adverse events reported in fentanyl patch group has no
statistical significant difference as compared to other opioid treatment. This result showed that transdermal fentanyl patches could be use as an alternative treatment in patients with moderate-to-severe chronic pain and who prefer non-invasive route of administration and much less frequent dosing. However, the outcome on addiction risk is limited.
