Chronic Use of Prescription Pain Medication and Outcomes in Patients with Burn Injury: A Burn Model System National Database Study

Kevin Vu; Huan Deng; Brian Kelter; Lauren Shepler; Barclay Stewart; Steven Wolf; Samuel Mandell; Alyssa Bamer; Anupam Mehta; Lewis Kazis; Colleen Ryan; Jeffrey Schneider

doi:10.1097/PHM.0000000000002448

Chronic Use of Prescription Pain Medication and Outcomes in Patients with Burn Injury: A Burn Model System National Database Study

Am J Phys Med Rehabil. 2024 Feb 12. doi: 10.1097/PHM.0000000000002448. Online ahead of print.

Authors

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA.
² Mass General Cancer Center, Massachusetts General Hospital, Boston, MA.
³ Department of Surgery, University of Texas Medical Branch, Galveston, TX.
⁴ Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
⁵ Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
⁶ Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Boston, MA.

PMID: 38363714
DOI: 10.1097/PHM.0000000000002448

Abstract

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 multi-center 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 months after injury. Regression analyses examined associations between pain medication use and outcomes at 12 months, adjusting for demographics, burn size, length of hospital stay, and pre-injury pain medication use and employment status. Outcomes included VR-12 Physical and Mental Component Summary scores (PCS and MCS), Patient-Reported Outcomes Measurement Information System (PROMIS-29) Anxiety and Depression scores, Satisfaction with Life Scale (SWLS), and employment status.

Results: Of 358 participants analyzed, prescription pain medication use was associated with worse outcomes at 12 months: PCS (β = -7.11, p < 0.001), MCS (β = -6.01, p < 0.001), and PROMIS-29 Depression (β = 4.88, p < 0.001) and Anxiety (β = 6.16, p < 0.001). SWLS 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 months (p = 0.035).

Conclusion: There is a significant association between prescription pain medication use and worse physical, mental, and employment outcomes at 12 months after burn injury.