The Impact of Comorbid Chronic Pain on Pharmacotherapy for Veterans with Post-Traumatic Stress Disorder

Alessandra A. Pratt; Katherine Hadlandsmyth; Michelle A. Mengeling; Emily B. K. Thomas; Kelly Miell; Sonya B. Norman; Brian C. Lund

doi:10.3390/jcm12144763

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The Impact of Comorbid Chronic Pain on Pharmacotherapy for Veterans with Post-Traumatic Stress Disorder

Journal article

Open access

Peer reviewed

The Impact of Comorbid Chronic Pain on Pharmacotherapy for Veterans with Post-Traumatic Stress Disorder

Alessandra A. Pratt, Katherine Hadlandsmyth, Michelle A. Mengeling, Emily B. K. Thomas, Kelly Miell, Sonya B. Norman and Brian C. Lund

Journal of clinical medicine, Vol.12(14), 4763

07/19/2023

DOI: 10.3390/jcm12144763

PMCID: PMC10380889

PMID: 37510878

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Abstract

Objective: Chronic pain can worsen PTSD symptomatology and may increase the risk of the prescription of multiple central nervous system (CNS)-active medications. The objective is to determine the impact of chronic pain on the number of CNS medications, including psychiatric medications, as well as the amount of medication changes. Methods: Veterans Affairs (VA) administrative data were used to identify VA-served Veterans with PTSD (N = 637,428) who had chronic pain (50.3%) and did not have chronic pain (49.7%) in 2020. The outcomes included the number of changes in psychiatric medications and the number of currently prescribed CNS-active mediations during a one-year observation period. Results: The number of changes in psychiatric medications was significantly higher for those with chronic pain (mean (M) = 1.8) versus those without chronic pain (M = 1.6) (Z = 38.4, p < 0.001). The mean number of concurrent CNS-active medications were significantly higher for those with chronic pain (M = 2.7) versus those without chronic pain (M = 2.0) (Z = 179.7, p < 0.001). These differences persisted after adjustment for confounding factors using negative binomial regression. Conclusions: Veterans with comorbid chronic pain and PTSD are at increased risk for a higher number of medication changes and for receiving CNS-active polytherapy.

Chronic Pain

Veterans

pharmacoepidemiology

PTSD

Details

Title: Subtitle: The Impact of Comorbid Chronic Pain on Pharmacotherapy for Veterans with Post-Traumatic Stress Disorder
Creators: Alessandra A. Pratt - Iowa City VA Health Care System
Katherine Hadlandsmyth - University of Iowa
Michelle A. Mengeling - University of Iowa
Emily B. K. Thomas - University of Iowa
Kelly Miell - Iowa City VA Health Care System
Sonya B. Norman - National Center for Post Traumatic Stress Disorder
Brian C. Lund - University of Iowa
Resource Type: Journal article
Publication Details: Journal of clinical medicine, Vol.12(14), 4763
DOI: 10.3390/jcm12144763
PMID: 37510878
PMCID: PMC10380889
NLM abbreviation: J Clin Med
ISSN: 2077-0383
eISSN: 2077-0383
Publisher: MDPI
Grant note: Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Health Services Research Center for Access & Delivery Research and Evaluation, Iowa City VA Health Care System U.S. Department of Veterans Affairs Health Services Research and Development (HSR&D) Service 03857 / U.S. Department of Veterans Affairs (VA) Office of Rural Health
Language: English
Date published: 07/19/2023
Academic Unit: Psychiatry; Epidemiology; Psychological and Brain Sciences; Emergency Medicine; Anesthesia; General Internal Medicine; Internal Medicine
Record Identifier: 9984448056802771

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