title: Bariatric Surgery Patients' Response to a Chronic Pain Rehabilitation Program.
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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA, Anilga_m@yahoo.com.
authors.forename: Anilga
authors.initials: A
authors.lastname: Tabibian
authors.forename: Karen B
authors.initials: KB
authors.lastname: Grothe
authors.forename: Manpreet S
authors.initials: MS
authors.lastname: Mundi
authors.forename: Todd A
authors.initials: TA
authors.lastname: Kellogg
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.forename: Cynthia O
authors.initials: CO
authors.lastname: Townsend
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D050110:Bariatric Surgery / Q000523:psychology; D016022:Case-Control Studies; D059350:Chronic Pain / Q000150:complications / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid