Patient-centered perspective on treatment outcomes in chronic pain.
OBJECTIVE
To define patient-determined success criteria for fibromyalgia and back pain treatment across four outcome domains: pain, fatigue, emotional distress, interference with daily activities.


METHODS
Retrospective correlational clinical sample design.


METHODS
Tertiary care clinics at health science center.


METHODS
248 fibromyalgia patients and 52 back pain patients.


METHODS
N/A.


METHODS
Patient Centered Outcomes Questionnaire, measures of usual pain intensity and pain unpleasantness.


RESULTS
Overall, for treatment to be considered successful, fibromyalgia patients required pain levels of 3.30 (54% reduction), fatigue levels of 3.08 (60% reduction), distress levels of 2.49 (60% reduction), and interference levels of 2.67 (63% reduction). Comparatively, back pain patients required pain levels of 2.23 (58% reduction), fatigue levels of 2.29 (57% reduction), distress levels of 1.65 (67% reduction), and interference levels of 1.81 (68% reduction). Overall, both fibromyalgia and back pain patients did not expect to meet their criteria for success.


CONCLUSIONS
Results highlight the importance of assessing the patient's view of successful outcome. Both fibromyalgia and back pain patients appear to have stringent criteria for success that existing treatments are often unlikely to meet. Comparison across groups indicated fibromyalgia patients have higher usual levels of pain, fatigue, distress, and interference. Interestingly, fibromyalgia patients also require greater changes across domains in order to consider treatment successful, despite rating higher levels of pain, fatigue, distress, and interference as successful. Recognizing patients' success criteria and treatment expectations encourages discussion and development of individualized treatment goals, and wider implementation of individualized treatment for chronic-pain populations is encouraged.
O'Brien
Erin M
EM
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA.
Staud
Roland M
RM
Hassinger
Alisa D
AD
McCulloch
Robert C
RC
Craggs
Jason G
JG
Atchison
James W
JW
Price
Donald D
DD
Robinson
Michael E
ME
D000203:Activities of Daily Living; D000328:Adult; D000704:Analysis of Variance; D001416:Back Pain / Q000523:psychology / Q000628:therapy; D002908:Chronic Disease; D004651:Employment; D005221:Fatigue / Q000209:etiology / Q000628:therapy; D005260:Female; D005356:Fibromyalgia / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology; D018710:Pain Clinics; D059408:Pain Management; D010147:Pain Measurement; D057285:Precision Medicine; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome