Multidisciplinary allocation of chronic pain treatment: effects and cognitive-behavioural predictors of outcome.
OBJECTIVE
Multidisciplinary treatment approaches have been found to be effective for chronic pain patients although there are large individual differences in outcomes. To increase overall treatment effects, tools are needed to identify patients most likely to benefit from tailored, comprehensive modular treatment schemes.


METHODS
The present study evaluates the effects of a multidisciplinary pain treatment allocation protocol in chronic pain patients and seeks to identify cognitive-behavioural predictors of outcome. Pain intensity, functional disability, depression, and use of medication in an intervention group of 110 chronic pain patients were compared to the outcomes of a 110 strong control group.


RESULTS
Paired pre- and post-treatment t tests showed that all primary outcomes had significantly decreased in the intervention group with ANCOVAs revealing a main group effect for post-treatment pain intensity levels and functional disability. Paired t tests demonstrated both variables to have significantly reduced after treatment relative to the levels reported by the control group. Predictor analyses further showed higher levels of acceptance to significantly predict larger reductions in pain intensity in the intervention but not in the control group.


CONCLUSIONS
The tested multidisciplinary allocation scheme for out-patient treatment of chronic pain complaints was effective in reducing pain intensity and functional disability. Findings also showed that especially those patients that are able to accept their condition are likely to profit most from the treatment in terms of pain reduction.
Samwel
Han J A
HJ
Department of Medical Psychology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. h.samwel@mps.umcn.nl
Kraaimaat
Floris W
FW
Crul
Ben J P
BJ
van Dongen
Robert D
RD
Evers
Andrea W M
AW
D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003191:Comprehensive Health Care; D003299:Cooperative Behavior; D005260:Female; D006380:Helplessness, Learned; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D018710:Pain Clinics; D059408:Pain Management; D010147:Pain Measurement; D010348:Patient Care Team; D011615:Psychotherapy, Group; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome