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Chronic Use of Prescription Pain Medication and Outcomes in Patients With Burn Injury: A Burn Model System National
Kevin Vu1, Huan Deng, Brian Kelter
1From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts (KV, HD, LS, LK, JS); Mass General Cancer Center, Massachusetts General Hospital, Boston, Massachusetts (BK); Division of Trauma, Burn and Critical Care Surgery, University of Washington, Seattle, Washington (BS); Harborview Injury Prevention and Research Center, Seattle, Washington (BS); Department of Surgery, University of Texas Medical Branch, Galveston, Texas (SW); Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas (SM); Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (AB); Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Boston, Massachusetts (AM); Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts (LK); Rehabilitation Outcomes Center at Spaulding, Spaulding Rehabilitation Network, Charlestown, Massachusetts (LK, JS); Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (CR); Shriners Hospitals for Children-Boston, Boston, Massachusetts (CR); and Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (JS).
Objective:
This study attempts to examine long-term pain medication usage after burn injury and its association with functional and psychosocial outcomes.
Design:
This is a multicenter retrospective cohort study utilizing the Burn Model System National Longitudinal Database. Participants injured from 2015 to 2021 were divided into two groups, those taking and not taking prescription pain medication at 12 mos after injury. Regression analyses examined associations between pain medication use and outcomes at 12 mos, adjusting for demographics, burn size, length of hospital stay, and preinjury pain medication use and employment status. Outcomes included VR-12 Physical and Mental Component Summary scores Patient-Reported Outcomes Measurement Information System Anxiety and Depression scores, Satisfaction with Life Scale, and employment status.
Results:
Of 358 participants analyzed, prescription pain medication use was associated with worse outcomes at 12 mos: Physical Component Summary (β = -7.11, P < 0.001), Mental Component Summary (β = -6.01, P < 0.001), and Patient-Reported Outcomes Measurement Information System Depression (β = 4.88, P < 0.001) and Anxiety (β = 6.16, P < 0.001). Satisfaction with Life Scale was not significantly associated with pain medication use ( P = 0.069) and those taking pain medication were 52% less likely to be employed at 12 mos ( P = 0.035).
Conclusions:
There is a significant association between prescription pain medication use and worse physical, mental, and employment outcomes at 12 mos after burn injury.
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