Predictors of attrition in an interdisciplinary pain management program.

Purpose/objective: This study sought to investigate the extent to which demographic and clinical characteristics predict which patients drop out of an interdisciplinary pain management program (IPP).

Research Method/design: Participants ( = 178 outpatients, 18-75 years of age) received treatment for various chronic pain conditions in an IPP (including biopsychosocial assessment, cognitive-behavioral, and physical therapies). Separate logistic regression analyses identified the demographic and clinical variables most predictive of attrition across five domains: (a) demographics, (b) number of medical and non/psychiatric diagnoses, (c) opioid use (yes versus no)/risk of misuse, (d) pain-related cognition and behavior, and (e) physical, social, and mental well-being.

Who Benefits from Chronic Opioid Therapy? Rethinking the Question of Opioid Misuse Risk.

Beginning in the late 1990s, a movement began within the pain management field focused upon the underutilization of opioids, thought to be a potentially safe and effective class of pain medication. Concern for addiction and misuse were present at the start of this shift within pain medicine, and an emphasis was placed on developing reliable and valid methods and measures of identifying those at risk for opioid misuse. Since that time, the evidence for the safety and effectiveness of chronic opioid therapy (COT) has not been established.

Long-term effectiveness of a comprehensive pain management program: strengthening the case for interdisciplinary care.

Chronic pain, a debilitating medical condition affecting approximately 15% of the US population, leads to individual suffering and costs to society in terms of health care dollars and lost productivity. To examine the effectiveness of a comprehensive pain management program, data from 108 program participants were evaluated. Preprogram, postprogram, and 6-month follow-up data were collected from 80 participants, and preprogram, postprogram, and 1-year data were collected from 46 participants.

Comparison of epidural Depo-Medrol vs. aqueous betamethasone in patients with low back pain.

Despite the popularity of epidural steroid injections for low back pain, there still remains a lack of consensus on which type of steroid to inject. Most comparison studies regarding epidural steroids are based on an assumption that different types of steroids are equal as long as equipotent doses are utilized. In the spring of 2002, a national shortage of all depo steroids allowed the authors to compare epidural methylprednisolone (Depo-Medrol) to a non depo form of betamethasone in patients with low back pain.

Can psychological distress be detected by response to a needle stick?

The purpose of this study was to determine whether an exaggerated response to a mildly painful stimulus would reflect abnormal levels of psychological distress in patients and, conversely, whether patients who show abnormal levels of psychological distress would have a low tolerance for a mildly painful stimulus. A total of 101 patients were given a mildly painful stimulus (30-gauge needle stick) and asked to record the amount of pain they felt on a scale of 0 to 10 (0 = no pain, 10 = severe pain). The mean response to the needle stick was a 1.

Outcomes of a pain management educational initiative at Baylor University Medical Center.

Baylor University Medical Center established a pain initiative group in 1996 to research the effectiveness of pain management throughout the hospital. After analyzing 300 patient surveys, the group undertook an intensive program to educate physicians, nurses, and patients regarding newer pain management techniques. The outcome of this educational initiative was reassessed in 2001 based on surveys completed by 100 patients after discharge.

A preliminary study of multidimensional pain inventory profile differences in predicting treatment outcome in a heterogeneous cohort of patients with chronic pain.

Objective: The objective was to evaluate whether the Multidimensional Pain Inventory (MPI) is effective for predicting response to interdisciplinary treatment in a heterogeneous group of patients with chronic pain. Changes in patients' profiles to a predominantly adaptive coping status after treatment also were assessed.

Design: A prospective study was conducted of patients with an array of pain conditions.