Chronic Pain Patients Face Unique Issues Staying on Medication

Medications found in blood and urine samples do not match what the patient says

(RxWiki News) People with chronic pain often have to follow strict medication regimens. Misreporting medication usage is more common and dangerous than people might think.

A recent study found that chronic pain patients incorrectly reported how much and what medication they were using.

The researchers suggested that chronic pain patients should have regular blood and urine tests to make sure they are using their medication correctly.

"Discuss your medication use with your doctor."

The lead author of this study was Andreas Schwarzer, MD, PhD, from the Department of Pain Management of BG Universitätsklinikum Bergmannsheil GmbH at Ruhr University in Bochum, Germany.

The participant data came from a pain center and surgical unit of a German University Hospital over a period of six months.

There were 243 consecutive outpatients who were visiting the pain center for the first time after a surgery.

The study also included 100 patients with current pain, who had not undergone surgery and were not undergoing any type of current pain medication treatment as the control group.

All participants filled out a questionnaire on their current medication use, gave blood and urine samples and underwent a psychiatric evaluation.

The findings showed that 122 of the participants (36 percent) had blood and/or urine samples that did not match their self-report of their medication usage.

Significantly more participants in the outpatient pain group incorrectly reported their medication use compared to the control group.

Forty-three percent of the outpatient pain group incorrectly reported their medication use versus 24 percent of the control group.

The researchers determined that there were three main factors significantly associated with incorrect medication use among the outpatient pain group:

  • High levels of depressive symptoms as determined by psychiatric testing
  • Reporting opioid use (opioids are potent pain relievers that trick the brain into feeling less pain, however they are highly addictive and can carry potentially dangerous side effects if not used correctly)
  • Having pain longer than 40 months

Compared to the participants in the outpatient pain group who did not have high levels of depressive symptoms, the participants in the outpatient pain group with high levels of depressive symptoms were 2.12 more likely to not use or take their medication correctly.

Reporting opioid use was associated with 70 percent increased odds of incorrect medication use for the outpatient pain participants compared to reporting other types of medication.

The outpatient participants who reported having pain for more than 40 months were 66 percent more likely to not take their medication correctly than the outpatient participants who had pain for less than 40 months.

Dr. Schwarzer and team determined that the combination of all three of these risk factors was associated with 4.7 times increased odds of a pain patient not using their medication correctly.

The findings showed that there were no significant factors associated with incorrect medication use in the control group.

One limitation of this study was that the researchers could not conduct follow-up interviews.

This study was published in the January/February edition of Pain Physician.

Dr. Eberhard and Partner Dortmund provided funding.

Review Date: 
February 21, 2014