Associations between pain coping and opioid use: One-month follow-up results of a prospective study in a cohort of traumatic injury patients

Authors

  • Jordan C. Smith, BS
  • Christopher R. Nicholas, PhD
  • Scott J. Hetzel, MS
  • Bri M. Deyo, MPH
  • Randall T. Brown, MD, PhD

DOI:

https://doi.org/10.5055/jom.2018.0445

Keywords:

opioids, pain catastrophizing, trauma, injury

Abstract

Objective: To examine associations between Pain Catastrophizing Scale (PCS) scores and daily opioid dosage in traumatic injury patients.

Design: This was a prospective cohort study with patient assessments at baseline and 1-month following discharge.

Setting: Study visits were conducted at a Regional Level I Trauma Center and by phone at follow-up.

Patients: Forty-nine injured inpatients completed baseline PCS. A subsample of 23 patients continued to take prescribed opioid medication at 1-month postdischarge and were included in the current analyses.

Main Outcome measured: Associations between baseline PCS and morphine equivalent daily dose (MEDD) at 1-month follow-up.

Results: Controlling for baseline MEDD, baseline PCS score was positively associated with MEDD at 1-month postdischarge (β = 0.577 [0.399, 1.535]; p = 0.002; R2 of PCS = 0.395).

Conclusions: In the current sample of traumatic injury inpatients, findings indicated that a baseline measure of pain catastrophizing predicts ongoing opioid medication use and dosage at 1-month postdischarge from an inpatient trauma unit.

Author Biographies

Jordan C. Smith, BS

Medical Student, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Christopher R. Nicholas, PhD

Faculty, Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Scott J. Hetzel, MS

Biostatistician, Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin

Bri M. Deyo, MPH

Research Project Coordinator, Department of Family Medicine and Public Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

Randall T. Brown, MD, PhD

Associate Professor, Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

References

Rudd RA: Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR. 2016; 65: 1445-1452. doi:10.15585/mmwr.mm655051e1.

Beaudoin FL, Straube S, Lopez J, et al.: Prescription opioid misuse among ED patients discharged with opioids. Am J Emerg Med. 2014; 32(6): 580-585. doi:10.1016/j.ajem.2014.02.030.

Holman JE, Stoddard GJ, Higgins TF: Rates of prescription opiate use before and after injury in patients with orthopaedic trauma and the risk factors for prolonged opiate use. J Bone Joint Surg Am. 2013; 95(12): 1075-1080. doi:10.2106/JBJS.L.00619.

Sullivan MJL: PCS–The Pain Catastrophizing Scale–User Manual. Montreal, Quebec: McGill University, 2009. Available at http://sullivan-painresearch.mcgill.ca/pdf/pcs/PCSManual_English.pdf. Accessed July 12, 2017.

Severeijns R, Vlaeyen JW, van den Hout MA, et al.: Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001; 17(2): 165-172.

Martel M, Wasan A, Jamison R, et al.: Catastrophic thinking and increased risk for prescription opioid misuse in patients with chronic pain. Drug Alcohol Depend. 2013; 132: 335-341. doi:10.1016/j.drugalcdep.2013.02.034.

Brown RT, Deyo B, Riley C, et al.: Screening in trauma for opioid misuse prevention (STOMP): Study protocol for the development of an opioid risk screening tool for victims of injury. Addict Sci Clin Pract. 2017; 12: 28-37.

Löwe B, Decker O, Müller S, et al.: Validation and standardization of the generalized anxiety disorder screener (gad-7) in the general population. Med Care. 2008; 46(3): 266-274. doi:10.1097/MLR.0b013e318160d093.

Martin A, Rief W, Klaiberg A, et al.: Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatry. 2006; 28(1): 71-77. doi:10.1016/j.genhosppsych.2005.07.003.

Tan G, Jensen MP, Thornby JI, et al.: Validation of the brief pain inventory for chronic nonmalignant pain. J Pain. 2004; 5(2): 133-137. doi:10.1016/j.jpain.2003.12.005.

Burton AK, Waddell G, Bartys S, et al.: Screening to identify people at risk of long-term incapacity: A conceptual and scientific review. Disabil Med. 2003; 3(3): 72-83.

Forsythe ME, Dunbar MJ, Hennigar AW, et al.: Prospective relation between catastrophizing and residual pain following knee arthroplasty: Two-year follow-up. Pain Res Manag. 2008; 13(4): 335-341.

Sullivan MJ, Stanish W, Waite H, et al.: Catastrophizing, pain, and disability in patients with soft-tissue injuries. Pain. 1998; 77(3): 253-260.

Valdes AM, Warner SC, Harvey HL, et al.: Use of prescription analgesic medication and pain catastrophizing after total joint replacement surgery. Semin Arthritis Rheum. 2015; 45(2): 150- 155. doi:10.1016/j.semarthrit.2015.05.004.

Granot M, Ferber SG: The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: A prospective study. Clin J Pain. 2005; 21(5): 439-445.

Papaioannou M, Skapinakis P, Damigos D, et al.: The role of catastrophizing in the prediction of postoperative pain. Pain Med Malden Mass. 2009; 10(8): 1452-1459. doi:10.1111/j.1526-4637.2009.00730.x.

Jacobsen PB, Butler RW: Relation of cognitive coping and catastrophizing to acute pain and analgesic use following breast cancer surgery. J Behav Med. 1996; 19(1): 17-29.

Helmerhorst GTT, Vranceanu A-M, Vrahas M, et al.: Risk factors for continued opioid use one to two months after surgery for musculoskeletal trauma. J Bone Joint Surg Am. 2014; 96(6): 495-499. doi:10.2106/JBJS.L.01406.

Holman JE, Stoddard GJ, Horwitz DS, et al.: The effect of preoperative counseling on duration of postoperative opiate use in orthopaedic trauma surgery: A surgeon-based comparative cohort study. J Orthop Trauma. 2014; 28(9): 502-506. doi:10.1097/BOT.0000000000000085.

Quartana PJ, Campbell CM, Edwards RR: Pain catastrophizing: A critical review. Expert Rev Neurother. 2009; 9(5): 745-758. doi:10.1586/ERN.09.34.

Published

07/02/2018

How to Cite

Smith, BS, J. C., C. R. Nicholas, PhD, S. J. Hetzel, MS, B. M. Deyo, MPH, and R. T. Brown, MD, PhD. “Associations Between Pain Coping and Opioid Use: One-Month Follow-up Results of a Prospective Study in a Cohort of Traumatic Injury Patients”. Journal of Opioid Management, vol. 14, no. 3, July 2018, pp. 159-63, doi:10.5055/jom.2018.0445.

Issue

Section

Brief Communication