CO099
Association de la prescription d'opioïdes avec les coûts médicaux, les coûts sociaux et la durée de l'incapacité de travail dans les douleurs musculo-squelettiques chroniques
HONG PHUOC
DUONG
(Bramois, Suisse)
Objective :
Opioids are commonly prescribed to patients with chronic musculoskeletal pain following orthopedic injuries, putting them at risk of increased costs and prolonged disability. The aim of this study was to assess the associations between opioid prescribing and healthcare costs, social costs, and work disability.
Material / Patients and Methods :
We consecutively recruited patients with chronic musculoskeletal pain admitted to a tertiary rehabilitation clinic in Switzerland between 2014 and 2021. Sociodemographic (age, sex, education, work accident), biopsychological (injury severity, location, pain biopsychosocial complexity assessed with the INTERMED, pain intensity, psychiatric comorbidity, depression, anxiety, pain catastrophizing, kinesiophobia), and opioid prescription data were collected at admission based on medical records. Healthcare costs, social costs, work disability were obtained from the insurance company up to 5 years after the accident. Prediction models were computed using multiple regression and Cox regression.
Results :
The study included 2314 patients. The median healthcare costs and social costs at 5 years (in 1000 CHF) were 49.1 (35.7-70.6) and 161.7 (99.4-276.5), respectively. The median duration of work disability was 692 (410-1013) days. On admission, 20% were prescribed opioids (median consumption: 11.7 mg per day). Opioid prescription was associated with higher healthcare costs (β=1.07, 95% CI= 1.00-1.15, p=0.04), social costs (β=1.09, 95% CI= 1.00-1.18, p=0.04) and longer duration of work disability (hazard ratio= 0.79; 95% CI= 0.71-0.88, p <0.001), after controlling for sociodemographic and other biopsychosocial factors.
Discussion - Conclusion :
Chronic opioid prescription, even with weak doses, is associated with higher costs and delayed return-to-work. Their prescription should be reduced in chronic musculoskeletal pain by considering alternative treatments
Keywords :
healthcare costs, social costs, work disability, opioids, biopsychosocial factors
Disclosure of interest :
The authors declare no conflicts of interest