Impact of ketamine infusions on healthcare utilization and chronic pain: a comparative effectiveness study with insights from real-world data

BACKGROUND: Previous studies provide conflicting evidence for ketamine's effectiveness in treating chronic pain, in the context of limited real-world evidence to augment clinical trial findings. We conducted a comparative effectiveness study with real-world data to assess the impact of ketamine infusions on pain-related healthcare utilization, to bridge the gap between clinical trials and real-life care. METHODS: We identified 118 subjects who received intravenous (IV) ketamine infusions for chronic pain between 2018 and 2022. Using the University of Pittsburgh's patient outcomes repository for treatment registry, we created a propensity score-matched control cohort of 118 subjects. Real-world data from the University of Pittsburgh Medical Center healthcare network was analyzed to compare unexpected pain-related healthcare utilization, including emergency room visits, urgent care visits, and hospital admissions. Utilization was assessed 6 months before and after ketamine infusion and compared with the matched control cohort. RESULTS: The ketamine cohort demonstrated a decrease in unexpected healthcare utilization 6 months after treatment compared with 6 months prior, while the control cohort showed an increase during the same period. Ketamine treatment was associated with a 45% reduction in pain-related visits compared with the control cohort (p