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Research project

MIS opioids: Minimal intervention strategy to de-implement opioid use

Status: Ongoing (1 June 2020 - 2026)

Development of a minimal intervention strategy (MIS) for de-implementing long lasting opioid use in primary care.

What we do

About our project

Every general practice manages patients with chronic musculoskeletal pain with long lasting opioid use. Yet the risk of serious side effects in this group of patients is relatively high and there is increasing evidence of doubts about the effectiveness and safety of opioids. A minimal intervention strategy (MIS) can be an effective and applicable intervention in primary care to achieve substantial health benefits for a large group of patients.

We hypothesize that with the help of a MIS the general practitioner can effectively approach and guide patients in effectively stopping the use of opioids.


  1. Descriptive study of long term opioid users in primary care within the IPCI-database.
  2. Literature study - overview of the efficacy of de-implementation interventions in patient with chronic pain on short and long term opioid treatment.
  3. Focus group study among short- and long term opioid-users; aiming at 3 focus groups of 7 patients.
  4. Focus group study among general practitioners; aiming at 2 focus groups of 7 general practitioners.
  5. Development of a MIS for general practitioners - based on the results of 1-4, the previous MIS on benzodiazepine + interviews with (other) experts; MIS (A) will focus on short term opioid users and MIS (B) will focus on long term opioid users.
  6. Testing the feasibility and initial effect of the MIS (A and B) in primary care (in two separate prospective studies, each in 10 general practices, 50 patients).

Our research focus

Primary outcome
Development of a minimal intervention strategy (MIS) to de-implement opioid use in chronic pain patient which can be used by the general practitioner to guide patients in stopping opioids.

Secondary outcomes

  1. Descriptive statistics on opioid use in general practice in the Netherlands based on the IPCI-database.
  2. Constructive overview on the efficacy of de-implementation interventions in short and long term users.

Funds & Grants

ZonMw (grant number 80-83911-98-1150).

Our team

Prof. dr. B.W. Koes (promotor), b.koes@erasmusmc.nl
Dr. A. Chiarotto (copromotor), a.chiarotto@erasmusmc.nl
Dr. MD H. Rijkels-Otters, j.rijkels-otters@erasmusmc.nl
Prof. Dr. P.J.E. Bindels, p.bindels@erasmusmc.nl

Contact address for the project: l.dekleijn@erasmusmc.nl.