Analgesic use in Vietnam veterans' with musculoskeletal pain
Date
2018
Authors
Kalisch Ellett, L.
Pratt, N.
Roughead, E.
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Journal article
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Journal of Military and Veterans' Health, 2018; 26(3):28-35
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Abstract
Background: International studies suggest that high-dose opioid use is more common in veterans with post-traumatic stress disorder (PTSD) than those without in the treatment of musculoskeletal pain.Purpose: This article aims to examine the use of analgesics by Australian veterans with musculoskeletal pain by conducting a drug utilisation evaluation and to examine use by PTSD status.Methods: A cross-sectional study of Vietnam veterans with musculoskeletal pain was conducted using Australian Government Department of Veterans' Affairs (DVA) data. The study reviewed the proportion of dispensed prescription analgesics between 1 July 2015 and 30 June 2016. The volume of opioids dispensed per veteran was calculated as oral morphine equivalents (OME). Results were stratified by PTSD status.Results: 10318 Vietnam veterans with musculoskeletal pain were included and 59% were dispensed analgesics. The most frequently dispensed analgesics were paracetamol (dispensed to 31% of veterans with PTSD and 28% without PTSD; p<0.01) and paracetamol with 30 mg codeine (19% of veterans with PTSD and 16% without; p<0.0001). Opioid analgesics were more likely to be dispensed to veterans with PTSD than without (35% v 32%, p=0.002); however, there was no significant difference in the volume dispensed (median of 1.2 [interquartile range (IQR) 0.4-5.8] OMEs per veteran per day for those with PTSD, compared to median 1.3 OMEs [IQR 0.4-6.3] per veteran per day for those without, p=0.3).Conclusion: Many veterans with service-related musculoskeletal pain did not receive prescription analgesics. Veterans with PTSD were more likely to be dispensed analgesics than those without, but PTSD did not appear to influence the volume of opioid dispensed.
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Copyright 2018 Australasian Military Medical Association