SOFMER / SFETD
Le 14/10/2021 de 09:00 à 11:00
La consommation d’opiacés est associée à la complexité biopsychosociale chez des patients adressés pour une réadaptation après traumatisme de l’appareil locomoteur
Cyrille Burrus (Sion, Suisse), Philippe Vuistiner (Sion, Suisse), Michel Konzelmann (Sion, Suisse), Bertrand Léger (Sion, Suisse), François Luthi (Sion, Suisse)
Objective : There is a worldwide crisis of opioid overuse and a need to better understand what factors are associated with it. Aim of the study: determine the influence of the biopsychosocial complexity on opioid use at admission in a vocational rehabilitation program of patients with persistent impairments after musculoskeletal trauma.
Material / Patients and Methods : Retrospective study of prospective data collected during a 6 years period. Comparison at admission of patients taking opioid analgesics with the rest of patients. Measure of the biopsychosocial complexity with the INTERMED tool (total score, and scores of the 4 subscales: biologic, psychologic, social, and health care system). Multiple logistic regression models with adjustment to numerous variables.
Results : Cohort of 3636 patients. 776 (21.3%) taking opioid analgesics. Every point increase on the INTERMED score (0 to 60) increases the odds for opioid usage of 1.04 (95% CI 1.02-1.06; p<0.001). When analysing subscales of the INTERMED scores, Biological, Psychological and Health care subscales are associated with opioid consumption, on the contrary to the Social score. Among other variables, pain severity, neuropathic pain, spine localization and a higher education are risk factors for opioid consumption.
Discussion - Conclusion : In our model, after adjustment to other variables, for a 10-point increase of biopsychosocial complexity with the INTERMED score, the odds of opioid consumption is increased by 48%. Other studies are needed to better understand the relationship and the way opioid overuse can be diminished. Next to other variables associated to opioid consumption, there is an interest to measure biopsychosocial complexity.
Keywords : Opioids - Chronic pain - Biopsychosocial complexity