Bariatric Surgery Patients’ Response to a Chronic Pain Rehabilitation Program

Anilga Tabibian, Karen Grothe, Manpreet S. Mundi, Todd A. Kellogg, Matthew M Clark, Cynthia O. Townsend

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Chronic pain (CP) is a prevalent and disabling diagnosis in obese individuals, but how bariatric surgery patients respond to chronic pain rehabilitation treatment programs has not previously been described.

Objectives: The aim of this study was to compare treatment outcomes of a chronic pain rehabilitation program (psychological and pain variables, medication use, treatment completion rates) for post-bariatric surgery patients to those of a non-bariatric surgery control group.

Setting: Three week outpatient multidisciplinary chronic pain program in an academic medical center.

Methods: This was a retrospective case-control study. Medical records of patients admitted to the Pain Rehabilitation Center at Mayo Clinic from 2008 to 2012 were reviewed. One hundred six patients with a history of bariatric surgery (cases) were identified and matched to 106 patients without a history of bariatric surgery (controls) on age, gender, and smoking status (n = 202). Matched t tests and McNemar’s tests were used for analyses.

Results: Mean age was 46 years; 91 % were female and 58 % were non-smokers. The majority of cases (71 %) had undergone Roux-en-Y gastric bypass. Bariatric patients had higher rates of benzodiazepine use at discharge (33 vs. 19 %, p = 0.0433) and were less likely to complete treatment (87 vs. 97 %, p = 0.007) compared to controls. Morphine equivalent use for cases was 127.3 mg ± 135.4 (n = 62) compared to 88.3 mg ± 95.3 (n = 62), p = 0.12, for controls at admission.

Conclusions: These results suggest that bariatric patients may be at risk for treatment non-adherence and have difficulty reducing medication use in the treatment of chronic pain.

Original languageEnglish (US)
JournalObesity Surgery
DOIs
StateAccepted/In press - Feb 28 2015

Fingerprint

Bariatric Surgery
Chronic Pain
Rehabilitation
Bariatrics
Therapeutics
Pain Clinics
Rehabilitation Centers
Gastric Bypass
Benzodiazepines
Morphine
Medical Records
Case-Control Studies
Outpatients
Smoking
Psychology
Pain
Control Groups

Keywords

  • Bariatric surgery
  • Chronic pain
  • Morphine equivalents
  • Opioid use

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Bariatric Surgery Patients’ Response to a Chronic Pain Rehabilitation Program. / Tabibian, Anilga; Grothe, Karen; Mundi, Manpreet S.; Kellogg, Todd A.; Clark, Matthew M; Townsend, Cynthia O.

In: Obesity Surgery, 28.02.2015.

Research output: Contribution to journalArticle

Tabibian, Anilga ; Grothe, Karen ; Mundi, Manpreet S. ; Kellogg, Todd A. ; Clark, Matthew M ; Townsend, Cynthia O. / Bariatric Surgery Patients’ Response to a Chronic Pain Rehabilitation Program. In: Obesity Surgery. 2015.
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abstract = "Background: Chronic pain (CP) is a prevalent and disabling diagnosis in obese individuals, but how bariatric surgery patients respond to chronic pain rehabilitation treatment programs has not previously been described.Objectives: The aim of this study was to compare treatment outcomes of a chronic pain rehabilitation program (psychological and pain variables, medication use, treatment completion rates) for post-bariatric surgery patients to those of a non-bariatric surgery control group.Setting: Three week outpatient multidisciplinary chronic pain program in an academic medical center.Methods: This was a retrospective case-control study. Medical records of patients admitted to the Pain Rehabilitation Center at Mayo Clinic from 2008 to 2012 were reviewed. One hundred six patients with a history of bariatric surgery (cases) were identified and matched to 106 patients without a history of bariatric surgery (controls) on age, gender, and smoking status (n = 202). Matched t tests and McNemar’s tests were used for analyses.Results: Mean age was 46 years; 91 {\%} were female and 58 {\%} were non-smokers. The majority of cases (71 {\%}) had undergone Roux-en-Y gastric bypass. Bariatric patients had higher rates of benzodiazepine use at discharge (33 vs. 19 {\%}, p = 0.0433) and were less likely to complete treatment (87 vs. 97 {\%}, p = 0.007) compared to controls. Morphine equivalent use for cases was 127.3 mg ± 135.4 (n = 62) compared to 88.3 mg ± 95.3 (n = 62), p = 0.12, for controls at admission.Conclusions: These results suggest that bariatric patients may be at risk for treatment non-adherence and have difficulty reducing medication use in the treatment of chronic pain.",
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N2 - Background: Chronic pain (CP) is a prevalent and disabling diagnosis in obese individuals, but how bariatric surgery patients respond to chronic pain rehabilitation treatment programs has not previously been described.Objectives: The aim of this study was to compare treatment outcomes of a chronic pain rehabilitation program (psychological and pain variables, medication use, treatment completion rates) for post-bariatric surgery patients to those of a non-bariatric surgery control group.Setting: Three week outpatient multidisciplinary chronic pain program in an academic medical center.Methods: This was a retrospective case-control study. Medical records of patients admitted to the Pain Rehabilitation Center at Mayo Clinic from 2008 to 2012 were reviewed. One hundred six patients with a history of bariatric surgery (cases) were identified and matched to 106 patients without a history of bariatric surgery (controls) on age, gender, and smoking status (n = 202). Matched t tests and McNemar’s tests were used for analyses.Results: Mean age was 46 years; 91 % were female and 58 % were non-smokers. The majority of cases (71 %) had undergone Roux-en-Y gastric bypass. Bariatric patients had higher rates of benzodiazepine use at discharge (33 vs. 19 %, p = 0.0433) and were less likely to complete treatment (87 vs. 97 %, p = 0.007) compared to controls. Morphine equivalent use for cases was 127.3 mg ± 135.4 (n = 62) compared to 88.3 mg ± 95.3 (n = 62), p = 0.12, for controls at admission.Conclusions: These results suggest that bariatric patients may be at risk for treatment non-adherence and have difficulty reducing medication use in the treatment of chronic pain.

AB - Background: Chronic pain (CP) is a prevalent and disabling diagnosis in obese individuals, but how bariatric surgery patients respond to chronic pain rehabilitation treatment programs has not previously been described.Objectives: The aim of this study was to compare treatment outcomes of a chronic pain rehabilitation program (psychological and pain variables, medication use, treatment completion rates) for post-bariatric surgery patients to those of a non-bariatric surgery control group.Setting: Three week outpatient multidisciplinary chronic pain program in an academic medical center.Methods: This was a retrospective case-control study. Medical records of patients admitted to the Pain Rehabilitation Center at Mayo Clinic from 2008 to 2012 were reviewed. One hundred six patients with a history of bariatric surgery (cases) were identified and matched to 106 patients without a history of bariatric surgery (controls) on age, gender, and smoking status (n = 202). Matched t tests and McNemar’s tests were used for analyses.Results: Mean age was 46 years; 91 % were female and 58 % were non-smokers. The majority of cases (71 %) had undergone Roux-en-Y gastric bypass. Bariatric patients had higher rates of benzodiazepine use at discharge (33 vs. 19 %, p = 0.0433) and were less likely to complete treatment (87 vs. 97 %, p = 0.007) compared to controls. Morphine equivalent use for cases was 127.3 mg ± 135.4 (n = 62) compared to 88.3 mg ± 95.3 (n = 62), p = 0.12, for controls at admission.Conclusions: These results suggest that bariatric patients may be at risk for treatment non-adherence and have difficulty reducing medication use in the treatment of chronic pain.

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