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General Rehabilitation

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

Thursday, November 16, 2023

    Primary Author(s)

  • KV

    Kevin Vu, MD

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

    • Co-Author(s)

  • HD

    Huan Deng, PhD

    research fellow
    Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School
    Charlestown, Massachusetts

  • BK

    Brian M. Kelter, Jr., Other

    Clinical Research Coordinator
    Massachusetts General Hospital - Boston, MA
    Boston, Massachusetts

  • LS

    Lauren Shepler, MPH

    Research Program Manager
    n/a
    Boston, Massachusetts

  • Steven E. Wolf, MD

    Professor, Department of Surgery
    University of Texas Medical Branch At Galveston School of Medicine
    Galveston, Texas

  • SM

    Samuel Mandell, MD, MPH

    Associate Professor
    n/a
    Dallas, Texas

  • AB

    Alyssa Bamer, MPH

    Research Scientist
    University of Washington
    Golden, Colorado

  • JS

    Jeffrey C. Schneider, MD

    Associate Professor
    Spaulding Rehabilitation Hospital
    Boston, Massachusetts

Background and/or Objectives: Prescription pain medication is commonly used to manage pain after burn injury. However, little is known about long-term prescription pain medication use after burn injury and its association with functional and psychosocial outcomes.

Design: This is a multi-center retrospective cohort study with two groups, burn patients taking and not taking prescription pain medication at 12 months after injury. Regression analyses adjusted for age, gender, race, ethnicity, burn size, hospital stay length, and pre-injury pain medication use examined associations between prescription pain medication use and functional and psychosocial outcomes.

Setting: This study utilizes the Burn Model System (BMS) National Database funded by the National Institute on Disability, Independent Living, and Rehabilitation Research.

Participants: Burn patients who enrolled in the BMS database between August 2015 and July 2021 and answered pain medication questions.

Interventions: Not applicable

Main Outcome Measures: VR-12 Physical and Mental Component Summary (PCS and MCS), Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, Pain Interference, and Pain Intensity, Satisfaction with Life Scale (SWLS), employment status.

Results: Of 358 patients, 12.3%, 77.7% and 41.5% reported prescription pain medication use at pre-injury, discharge, and 12-month follow-up, respectively. Among all patients with prescription pain medication use at discharge, 88.4% of them were discharged with at least one opioid medication. Analyses demonstrated an association between prescription pain medication use at 12 months and worsened outcomes: decreased MCS (p < 0.001) and PCS (p < 0.001) scores and increased PROMIS Depression (p < 0.001), Anxiety (p < 0.001), and Pain Interference (p < 0.001) scores. The prescription pain medication group also scored on average 2.16 points higher on PROMIS Pain Intensity ratings and were 52% less likely to be employed at 12 months. Only SWLS was not significantly associated with pain medication use (p=0.065).

Conclusions: There is a significant association with prescription pain medication use and worsened physical, mental, and employment outcomes at 12 months after burn injury.