Predicting completion of a cognitive-behavioral pain management program by initial measures of a chronic pain patient' s readiness for change.
OBJECTIVE
There is a need to identify pretreatment patient indicators, which are predictive of the successful enrollment and completion of chronic pain treatment programs. Recent evidence suggests the Pain Stages of Change Questionnaire can predict enrollment and completion of a 10-session cognitive-behavioral pain management program. The purpose of this study is to determine whether the pretreatment Stages of Change Questionnaire can predict patients who would complete a cognitive-behavioral pain treatment program.


METHODS
Prospective cohort study using logistic regression analyses.


METHODS
Patients referred for a 10-session cognitive-behavioral treatment program at a tertiary care multidisciplinary pain clinic or a community-based specialty clinic.


METHODS
Three hundred chronic pain patients (151 in the tertiary setting and 149 in the community-based setting) participated, with 147 of the patients (49%) completing and 153 (51%) patients not completing the 10-session program.


METHODS
Ten-visit cognitive-behavioral program for chronic pain patients.


METHODS
Completion of program.


RESULTS
The Stages of Change Questionnaire scores could predict completion status chi2 (N = 300, 2 df) = 39.7, p <0.001, (goodness-of-fit test chi2 = 5.69, p = 0.68). Those patients completing the program were slightly older and reported higher levels of pain, depression, and disability than did those patients who did not complete. Low "Precontemplation" score remained the best single predictor, as it identified correctly 61% of the cases patients who completed the program and predicted who would drop out in 65% of the cases.


CONCLUSIONS
The Stages of Change Questionnaire is a potentially useful tool; however, the current scoring method is insufficient to recommend its use as an inclusion or exclusion criterion for enrollment in a cognitive-behavioral program.
Biller
N
N
Center for Psychosocial Medicine, University of Goettingen, Germany.
Arnstein
P
P
Caudill
M A
MA
Federman
C W
CW
Guberman
C
C
D000328:Adult; D001294:Attitude to Health; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D059408:Pain Management; D010352:Patient Dropouts; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012803:Sick Role; D011795:Surveys and Questionnaires