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Catastrophic thinking cited as predictor of continued opioid use after musculoskeletal trauma
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Patients who self-report continued opioid use 1 month to 2 months after surgery for musculoskeletal trauma have more psychological distress and less effective coping strategies than patients not on these medications, according investigators of this study.
“Patients who scored higher on the catastrophic thinking, anxiety, post-traumatic stress disorder, and depression questionnaires were significantly more likely (P< 0.001) to report taking opioid pain medications one to two months after surgery, regardless of injury severity, fracture site, or treating surgeon,” the researchers wrote in their study abstract.
Investigators with the Orthopaedic Hand and Upper Extremity Service, at Massachusetts General Hospital in Boston studied 145 patients at 1 month to 2 months following surgery and asked them to indicate whether they were taking opioid pain medication. The patients completed a variety of depression, pain stress tests and the SF-36 Musculoskeletal Function Assessment Questionnaire for disability and the Abbreviated Injury Scale.
The researchers also found a higher magnitude of disability among patients who reported using opioids. According to logistic regression model not including pain intensity, catastrophic thinking was the best predictor of reported opioid use, explaining 23% of variance.
Disclosure: Vrahas has stock in Pioneer Surgical and has received travel accommodations from the AO Foundation. Vranceanu received a grant from the Orthopedic Trauma Association. Ring is a consultant for Wright Medical and Skeletal Dynamics; provided expert testimony for multiple malpractice and personal injury lawsuits; received honoraria and per diem from AO North America, AO International and several universities; received royalties from Wright Medical, Skeletal Dynamics and Medartis; and has stock options in Illuminos.
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