Use of prescription analgesic medication and pain catastrophizing after total joint replacement surgery

Ana M Valdes, Sophie C Warner, Hollie L Harvey, Gwen S Fernandes, Sally Doherty, Wendy Jenkins, Maggie Wheeler, Michael Doherty

Research output: Contribution to journalArticle (Academic Journal)

14 Citations (Scopus)

Abstract

OBJECTIVE: To survey the use of analgesic medication 4.8 years after total joint replacement (TJR) surgery and assess the determinants of medication usage.

PATIENTS AND METHODS: Of 852 patients who had undergone TJR for osteoarthritis were recruited from secondary care. Participants (mean age, 73.7 years) responded to a questionnaire on medication use, physical function and pain (WOMAC, VAS and body pain), pain catastrophizing and illness behaviour (somatization).

RESULTS: Only 37% of study participants were not on any pain relief medication, 25.1% were taking opioids, 6.9% were taking prescription NSAIDs and 25.9% were taking only non-prescription analgesics. Use of NSAIDs correlated with presence of back pain, body pain and high illness behaviour. The strongest associations with use of opioids were severe joint pain, high pain catastrophizing, body and back pain. After adjustment for covariates plus presence of pain, catastrophizing remained significantly associated with higher risk of opioid use (OR = 1.66, 95% CI: 1.13-2.43, p < 0.009) and of other prescription medication that can be used to treat pain (anti-depressants, anti-epileptics and hypnotics) (OR = 2.52, 95% CI: 1.61-3.95, p < 0.0005).

CONCLUSIONS: Use of opioid medication 4 years post-TJR is very high in our study population. In addition to joint, back and body pain, a major contributor to opioid use is pain catastrophizing. Our data suggest that current opioid and other analgesic prescribing patterns may benefit from considering the catastrophizing characteristics of patients.

Original languageEnglish
Pages (from-to)150-5
Number of pages6
JournalSeminars in Arthritis and Rheumatism
Volume45
Issue number2
DOIs
Publication statusPublished - Oct 2015

Keywords

  • Aged
  • Aged, 80 and over
  • Analgesics/therapeutic use
  • Arthroplasty, Replacement/adverse effects
  • Catastrophization/psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis/surgery
  • Pain Measurement
  • Pain, Postoperative/drug therapy
  • Treatment Outcome

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