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Pain with neuropathic characteristics after surgically treated lower limb fractures : cost analysis and pain medication use
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Png, May Ee, Costa, Matthew L., Petrou, Stavros, Achten, Juul, Knight, Ruth, Bruce, Julie and Keene, David J. (2023) Pain with neuropathic characteristics after surgically treated lower limb fractures : cost analysis and pain medication use. British Journal of Pain, 17 (5). pp. 428-437. doi:10.1177/20494637231179809 ISSN 2049-4637.
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Official URL: http://dx.doi.org/10.1177/20494637231179809
Abstract
Introduction
Neuropathic pain is prevalent among people after lower limb fracture surgery and is associated with lower health-related quality of life and greater disability. This study estimates the financial cost and pain medication use associated with neuropathic pain in this group.
Methods
A secondary analysis using pain data collected over six postoperative months from participants randomised in the Wound Healing in Surgery for Trauma (WHiST) trial. Pain states were classified as pain-free, chronic non-neuropathic pain (NNP) or chronic neuropathic pain (NP). Cost associated with each pain state from a UK National Health Service (NHS) and personal social services (PSS) perspective were estimated by multivariate models based on multiple imputed data. Pain medication usage was analysed by pain state.
Results
A total of 934 participants who provided either 3- or 6-months pain data were included. Compared to participants with NP, those with NNP (adjusted mean difference -£730, p = 0.38, 95% CI −2368 to 908) or were pain-free (adjusted mean difference -£716, p = 0.53, 95% CI −2929 to 1497) had lower costs from the NHS and PSS perspective in the first three postoperative months. Over the first three postoperative months, almost a third of participants with NP were prescribed opioids and 8% were prescribed NP medications. Similar trends were observed by 6 months postoperatively.
Conclusion
This study found healthcare costs were higher amongst those with chronic NP compared to those who were pain-free or had chronic NNP. Opioids, rather than neuropathic pain medications, were commonly prescribed for NP over the first six postoperative months, contrary to clinical guidelines.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
Journal or Publication Title: | British Journal of Pain | ||||||
Publisher: | Sage Publications Ltd. | ||||||
ISSN: | 2049-4637 | ||||||
Official Date: | October 2023 | ||||||
Dates: |
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Volume: | 17 | ||||||
Number: | 5 | ||||||
Page Range: | pp. 428-437 | ||||||
DOI: | 10.1177/20494637231179809 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) |
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