LONG-TERM TRANSCUTANEOUS ELECTRICAL NERVE-STIMULATION (TENS) USE - IMPACT ON MEDICATION UTILIZATION AND PHYSICAL THERAPY COSTS

Objective: A study was conducted to assess a variety of treatment outc omes in longterm users of transcutaneous electrical nerve stimulation (TENS) who suffer from chronic pain. Key components of the study exami ned the effects of long-term TENS therapy on pain-related medications and physical/occupational therapy (PT/OT) use. Design: From a populati on of 2.003 chronic pain patients (CPPs) who acquired a TENS device (E pix XL(R), Empi, Inc., St. Paul, MN, U.S.A.) for pain management, a ra ndomly selected sample of 376 patients who used TENS were interviewed by telephone by an independent research firm. The survey assessed a va riety of outcome variables including changes in medication use, number of pain-related medications, and use of PT/OT prior to TENS and after a minimum 6 months of TENS treatment. The data were subjected to a pa ired t test analysis. A cost simulation model was then applied to the medication and PT/OT data. Results: The mean duration of pain, for whi ch TENS was prescribed, was 40 +/- 60 months. As compared with the per iod prior to TENS use, this long-term TENS user group reported a stati stically significant reduction in the following types of pain medicati ons: opiate analgesics, tranquilizers, muscle relaxants, nonsteroidal anti-inflammatory drugs (NSAIDs), and steroids. PT/OT use was also sig nificantly reduced. Cost simulations of pain medications and PT/OT are presented. Conclusions: Long-term use of TENS is associated with a si gnificant reduction in the utilization of pain medication and PT/OT. I n this study population. cost simulations of medication and PT/OT indi cate that with long-term TENS use, costs can be reduced up to 55% for medications and lip to 69% for PT/OT. The potential for TENS associate d improvement. combined with reduced medication-related complications and costs, are important points that clinicians should consider when c onstructing a treatment plan for chronic pain patients. Finally, cost simulation techniques provide a useful tool for assessing outcomes in pain treatment and research.