Png, May Ee, Costa, Matthew L, Petrou, Stavros, Achten, Juul, Knight, Ruth 
ORCID: 0000-0001-6810-2845, 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.
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Abstract
<h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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, <i>p</i> = 0.38, 95% CI -2368 to 908) or were pain-free (adjusted mean difference -£716, <i>p</i> = 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.<h4>Conclusion</h4>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: | Article |
|---|---|
| Uncontrolled Keywords: | Pain, postoperative, musculoskeletal pain, neuropathic pain, injury, orthopaedic surgery, financial cost, medication |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 27 Apr 2023 07:30 |
| Last Modified: | 23 Dec 2023 01:53 |
| DOI: | 10.1177/20494637231179809 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3169997 |
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