Inpatient vs. outpatient pain management: results of a randomised controlled trial.
Inpatient and outpatient cognitive behavioural pain management programmes for mixed chronic pain patients were compared. Patients were randomly allocated to the 4 week inpatient programme or to the 8 half day per week outpatient programme, or to a waiting list control group. Staff, teaching materials, and setting were the same for the two treatment groups. Patients were assessed pre-treatment, and at 1 month after discharge, and treated patients also at 6 months and 1 year after discharge, by assessors blind to treatment group; assessments included physical, functional and psychological measures, and medication use. In total, 121 mixed chronic pain patients (mean age 50 years; mean chronicity 8.1 years) were included in the study, following medical examination to ensure that no further medical treatment was appropriate. There was no change in the control group; inpatients and outpatients, comparable before treatment, both made significant improvements in physical performance and psychological function, and reduced medication use. Inpatients made greater gains, and maintained them better at 1 year; they also used less health care than outpatients. There were no outstanding predictors of improvement other than treatment group.
de Williams
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CAC
Inpatient Pain Management Unit, Guy's and St Thomas' Hospital Trust, St Thomas' Hospital,London, SE1 7EH,UK Division of Psychiatry and Psychology, United Medical and Dental Schools, St Thomas' Campus,London, SE1 7EH,UK Lewisham and Guy's Mental Health NHS Trust, Guy's Hospital,London SE1 9RT,UK Guy's and St Thomas' Hospital Trust, St Thomas' Hospital,London SE1 7EH,UK Trinity Hospice,London,UK Department of Medicine, United Medical and Dental Schools, St Thomas' Campus,London, SE1 7EH,UK Pain Management and Research Centre, Royal North Shore Hospital,Sr. Leonards, NSW 2065,Australia.
Richardson
P H
PH
Nicholas
M K
MK
Pither
C E
CE
Harding
V R
VR
Ridout
K L
KL
Ralphs
J A
JA
Richardson
I H
IH
Justins
D M
DM
Chamberlain
J H
JH
D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care