Factors associated with persistent opioid use after an upper extremity fracture

Area of Science:

• Orthopedics
• Psychology
• Public Health

Background:

• Opioid misuse and dependence pose a significant public health crisis.
• Addressing the whole-person needs, including medical and psychosocial aspects, is crucial for effective patient care.
• Understanding factors influencing persistent opioid use after injury is key to minimizing misuse and dependence.

Purpose of the Study:

• To investigate patient factors associated with opioid use following upper limb fractures.
• To analyze associations at two to four weeks and six to nine months post-injury.
• To identify potential targets for intervention in pain management and opioid risk reduction.

Main Methods:

• Recruited 734 patients with isolated upper limb fractures.
• Collected retrospective and prospective opioid prescription data.
• Utilized validated questionnaires for demographics, injury data, depression, anxiety, social support, pain catastrophizing, self-efficacy, and kinesiophobia.

Main Results:

• Opioid prescription at 2-4 weeks was linked to less social support, less instrumental support, and more anxiety.
• Opioid prescription at 6-9 months was associated with less instrumental support and more anxiety.
• Anxiety symptoms and reduced social/instrumental support were significant predictors of opioid use.

Conclusions:

• Potentially modifiable psychosocial factors are associated with acute and chronic opioid prescriptions after upper limb fractures.
• Surgeons should be aware of and screen for emotional and social health in patients prescribed opioids.
• Integrating psychosocial assessments may improve pain management and reduce opioid misuse.