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Bariatric Surgery Patients’ Response to a Chronic Pain Rehabilitation Program

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Abstract

Background

Chronic pain (CP) is a prevalent and disabling diagnosis in obese individuals, but how bariatric surgery patients respond to chronic pain rehabilitation treatment programs has not previously been described.

Objectives

The aim of this study was to compare treatment outcomes of a chronic pain rehabilitation program (psychological and pain variables, medication use, treatment completion rates) for post-bariatric surgery patients to those of a non-bariatric surgery control group.

Setting

Three week outpatient multidisciplinary chronic pain program in an academic medical center.

Methods

This was a retrospective case-control study. Medical records of patients admitted to the Pain Rehabilitation Center at Mayo Clinic from 2008 to 2012 were reviewed. One hundred six patients with a history of bariatric surgery (cases) were identified and matched to 106 patients without a history of bariatric surgery (controls) on age, gender, and smoking status (n = 202). Matched t tests and McNemar’s tests were used for analyses.

Results

Mean age was 46 years; 91 % were female and 58 % were non-smokers. The majority of cases (71 %) had undergone Roux-en-Y gastric bypass. Bariatric patients had higher rates of benzodiazepine use at discharge (33 vs. 19 %, p = 0.0433) and were less likely to complete treatment (87 vs. 97 %, p = 0.007) compared to controls. Morphine equivalent use for cases was 127.3 mg ± 135.4 (n = 62) compared to 88.3 mg ± 95.3 (n = 62), p = 0.12, for controls at admission.

Conclusions

These results suggest that bariatric patients may be at risk for treatment non-adherence and have difficulty reducing medication use in the treatment of chronic pain.

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Conflict of interest

All contributing authors, Anilga Tabibian, Karen B. Grothe, Manpreet S. Mundi, Todd A. Kellogg, Matthew M. Clark, and Cynthia O. Townsend, declare that they have no conflict of interest.

A Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

A Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Disclosures

None.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Anilga Tabibian, Karen B. Grothe & Matthew M. Clark

  2. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA

    Manpreet S. Mundi

  3. Department of General Surgery, Mayo Clinic, Rochester, MN, USA

    Todd A. Kellogg

  4. VA Health Care System, Minneapolis, MN, USA

    Cynthia O. Townsend

Authors
  1. Anilga Tabibian
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  2. Karen B. Grothe
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  3. Manpreet S. Mundi
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  4. Todd A. Kellogg
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  5. Matthew M. Clark
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  6. Cynthia O. Townsend
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Correspondence to Anilga Tabibian.

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Tabibian, A., Grothe, K.B., Mundi, M.S. et al. Bariatric Surgery Patients’ Response to a Chronic Pain Rehabilitation Program. OBES SURG 25, 1917–1922 (2015). https://doi.org/10.1007/s11695-015-1634-6

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  • DOI: https://doi.org/10.1007/s11695-015-1634-6

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