title: Satisfaction with treatment for chronic pain in a specialty service: preliminary prospective results.
abstract: Treatment satisfaction is an increasingly popular outcome measure in pain management. While it is a subjective variable, it may nonetheless reflect the quality of care and it may predict other important patient behaviors. The purpose of this study was to prospectively evaluate predictors of satisfaction with treatment for chronic pain. Subjects included 62 adults seeking treatment for pain at a community-based, specialty clinic. Treatment included combinations of analgesic medications (e.g., opioids, tricyclic antidepressants) and procedures performed by anesthesiologists (e.g., epidural steroid injections, facet joint blocks). Subjects completed measures of pain severity, depression, disability, and pain-related anxiety, prior to treatment and at a 6-month follow-up. Follow-up assessment also included measures of treatment satisfaction and characteristics of the patient's clinic experience and a chart review to assess medications, procedures, and number of visits. Comparison of baseline and follow-up data showed statistically significant reductions in pain (25%) and depression. Most patients were satisfied (45.6%) or extremely satisfied (43.9%) with the treatment they received (10.5% was somewhat satisfied, none were dissatisfied). Correlation analyses showed that patient demographic variables did not predict treatment satisfaction. Changes in pain, depression, and pain-related anxiety were associated with treatment satisfaction but change in pain was a relatively weak predictor. Nine of the 16 characteristics of the patient's clinic experience correlated with treatment satisfaction. Regression analyses showed that the strongest unique predictors of treatment satisfaction were the patients feeling their evaluation was complete, believing they received an explanation for clinic procedures, and finding that treatment helped them improve their daily activity.
authors.affiliation: Department of Psychiatry, The University of Chicago, Chicago, USA. lance.mccracken@rnhrd-tr.swest.nhs.uk
authors.forename: Lance M
authors.initials: LM
authors.lastname: McCracken
authors.forename: Donna
authors.initials: D
authors.lastname: Evon
authors.forename: Eleftheria T
authors.initials: ET
authors.lastname: Karapas
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D002908:Chronic Disease; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology; D018710:Pain Clinics / Q000706:statistics & numerical data*; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000700:Analgesics