title: The COPE program: treatment efficacy and medical utilization outcome of a chronic pain management program at a major military hospital.
abstract: This study presents a treatment efficacy and medical utilization evaluation of a cognitive-behavioral, outpatient, chronic pain management program in a military hospital setting. A total of 61 nonmalignant chronic pain patients with heterogeneous pain syndromes who participated in sequential group programs were included in the study. Comprehensive and multi-dimensional outcome criteria were used, including pain ratings, relaxation skills, quality of life, satisfaction ratings, and medical utilization. The findings demonstrated improvements on all general indices. Military status had no effect on any of the outcome measures. Most significant was an 87% reduction in outpatient clinic visits in the first 3 months after treatment. This reduction amounts to a projected net annual saving of $78,960 in the first year after behavioral medicine intervention. In light of the increasing cost of health care for chronic pain patients, psychological approaches as an adjunct to traditional medical care seem to present a sound solution for cost savings. This study also supports the notion that a strategic biopsychosocial pain program, which targets the multiple dimensions of persistent pain, provides effective treatment and increases patient satisfaction.
authors.affiliation: Multi-Disciplinary Pain Clinic, Department of Psychology/Behavioral Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA.
authors.forename: L
authors.initials: L
authors.lastname: Peters
authors.forename: E P
authors.initials: EP
authors.lastname: Simon
authors.forename: R A
authors.initials: RA
authors.lastname: Folen
authors.forename: V
authors.initials: V
authors.lastname: Umphress
authors.forename: L
authors.initials: L
authors.lastname: Lagana
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data*; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D017046:Cost Savings; D005260:Female; D006254:Hawaii; D006302:Health Services Research; D006772:Hospitals, Military / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008887:Military Medicine / Q000191:economics / Q000379:methods*; D008889:Military Personnel / Q000523:psychology*; D010146:Pain / Q000175:diagnosis / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D015397:Program Evaluation; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome