Treatment Outcomes Among Individuals in a Musculoskeletal Pain Rehabilitation Program Related to the Prevalence and Trends in the Dispensing of Prescribed Medications

Abstract

Objectives: Prescribed medication consumption for chronic, non-malignant pain may not be beneficial. This study investigated how self-reported treatment outcomes among individuals in a musculoskeletal pain rehabilitation program are related to the prevalence and trends in the dispensing of prescribed medications.

Methods: Patients with musculoskeletal pain were recruited as they began a rehabilitation program. Each participant completed a self-administrated questionnaire on pain, health status and socioeconomic factors in the beginning and at the end of the rehabilitation period. Each individual’s baseline data from the rehabilitation sample was linked to the national Norwegian Prescription Database [2004–2010]. Dispensing prescribed medications in the groups of centrally acting analgesics [opioids], anxiolytics and hypnotics were studied.

Results: A total of 1562 individuals participated, and there was no loss to follow-up. Controlled medications [Schedule 2] were prescribed in 36.4% [n = 569] of the sample population. Women were overrepresented in the sample. The dispensing of prescribed hypnotics is more frequent than the dispensing of prescribed analgesics and anxiolytics. Old age, low education level and living alone are related to being prescribed hypnotics and anxiolytics, while gender [female] is related to being prescribed analgesics. A reduction in pain intensity over the two observations in time [pre- and post-treatment] is related to the prescription of hypnotics, while a lack of improvement in physical capacity during the rehabilitation program is significantly related to being prescribed analgesics. The improvement in overall health is significantly related to being prescribed anxiolytics.

Conclusions: Dispensing of prescribed analgesics, anxiolytics and hypnotics among individuals in rehabilitation with chronic musculoskeletal pain is associated with treatment outcomes and should be taken into account in designing the rehabilitation intervention.

• chronic pain
• multidisciplinary rehabilitation
• prescription database
• prescribed medications
• treatment outcomes

Acknowledgements

The authors wish to thank all patients and personnel at the rehabilitation centers involved. They offer a special thank you to Aud Ramberg for assistance in database management.