Weight Status among Prescription Opioid Users with Chronic Pain
Bigand, Teresa Louise
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Background: Greater than 70% of the United States (US) adult population is overweight as defined by body mass index (BMI) greater than 25 kg/m2. Adults who are overweight are more likely to report chronic pain than those with recommended weight status. Additionally, higher BMI is correlated with poorer pain outcomes. Patients with chronic pain and overweight status report difficulty self-managing pain and weight and are commonly prescribed opioid medications to treat pain. Long-term use of prescription opioids is associated with negative health outcomes, especially among adults with overweight status. Adults with chronic pain report many health symptoms that hinder pain and weight self-management such as poor quality of sleep, high levels of depression, low levels of self-efficacy for symptom management, high levels of pain interference, and high pain intensity. However, the relationships between health symptoms among adults with pain who use prescription opioids remain unclear. Methods: Using the Individual and Family Self-Management Theory, a secondary analysis of a survey study was conducted to determine relationships between health factors of sleep quality, depression, self-efficacy for symptom management, pain interference, pain intensity, and weight status. The target population was adults ages 18 years and older with self-reported chronic pain taking prescription opioids for either opioid use disorder or chronic pain treatment. Results were analyzed in SPSS software. Regression models were conducted to evaluate relationships. Study Findings and Implications: The results gained from this investigation identified that weight status is an important consideration in pain interference. Analyzing pain interference as the outcome, it was found that BMI acted as an effect modifier between all health factors and pain interference. Thus, a high BMI significantly increased pain interference in the context of poor sleep quality, high levels of depressive symptoms, and low levels of self-efficacy. Future research efforts should concentrate on developing targeted interventions to help patients with chronic pain manage symptoms through weight self-management. Successful implementation of research-driven interventions may facilitate methods for sustainable weight control and pain self-management which could potentially reduce the need for long-term prescription of opioid medications in this high-risk population.