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Use of pain medication before and after inpatient musculoskeletal rehabilitation

The objective of this study was to identify subgroups among the participants in
inpatient multidisciplinary musculoskeletal rehabilitation based on the
differences in the shapes of trajectories of pain medication consumption during
the 9 years around the time of intervention. A register-based study among 4578
public sector employees was conducted. Group-based trajectory analysis was done
on the purchase of prescribed pain medications during the 9 years around the time
of rehabilitation.
The participants were on an average 50.7 (SD=6.6) years of
age, and 2955 (86%) were women. Average yearly purchase of pain medications
increased during the follow-up period from 73.4 (SD=193.0) to 163.3 (SD=295.7)
defined daily doses. The analysis suggested six-cluster model. The shapes of the
trajectories of three clusters did not show any steep slopes, one trajectory
demonstrated nonstop rising through the entire follow-up, and one trajectory was
closed to the trajectory average of medication use. One trajectory (11% of the
sample) demonstrated a steep growth before the intervention and steep drop after
it. When comparing this cluster with all other clusters combined, odds ratios
were 0.40 [95% confidence interval (CI): 0.19-0.85] for age group (older vs.
younger), 0.78 (95% CI: 0.61-1.01) for sex (women vs. men), and 1.44 (95% CI:
1.09-1.90) for occupational status (lower vs. higher). In other words, the
participants belonged to this cluster were younger employees with a lower
occupational grade. It seems that younger employees in manual jobs benefitted of
the studied multidisciplinary musculoskeletal rehabilitation the most, especially
when the timing of intervention is bounded to the substantial rise of pain
severity.

Langue : ANGLAIS

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