The Canadian STOP-PAIN project - Part 1: Who are the patients  on the waitlists of multidisciplinary pain treatment facilities?
OBJECTIVE
The Canadian STOP-PAIN Project assessed the human and economic burden of chronic pain in individuals on waitlists of Multidisciplinary Pain Treatment Facilities (MPTF). This article presents the patients' bio-psycho-social profile.


METHODS
A sample of 728 patients was recruited from waitlists of eight university-affiliated MPTFs across Canada. Subjects completed validated questionnaires to: 1) assess the characteristics and impact of their pain; and 2) evaluate their emotional functioning and quality of life (QoL). Follow-up questionnaires were completed by a subgroup of 271 patients three months later.


RESULTS
Close to 2/3 of the participants reported severe pain (> or = 7/10) that interfered substantially with various aspects of their daily living and QoL. Severe or extremely severe levels of depression were common (50.0%) along with suicidal ideation (34.6%). Patients aged > 60 yr were twice as likely to experience severe pain (> or = 7/10) as their younger counterparts (P = 0.002). Patients with frequent sleep problems were more at risk of reporting severe pain (P < or = 0.003). Intense pain was also associated with a greater tendency to catastrophize (P < 0.0001) severe depressive symptoms (P = 0.003) and higher anger levels (P = 0.016). Small but statistically significant changes in pain intensity and emotional distress were observed over a three-month wait time (all P < 0.05).


CONCLUSIONS
This study highlights the severe impairment that patients experience waiting for treatment in MPTFs. Knowing that current facilities cannot meet the clinical demand, it is clear that effective prevention/treatment strategies are needed earlier in primary and secondary care settings to minimize suffering and chronicity.
Choinière
Manon
M
Centre de recherche du Centre hospitalier de l'Université de Montréal, QC, Canada. manon.choiniere.chum@ssss.gouv.qc.ca <manon.choiniere.chum@ssss.gouv.qc.ca>
Dion
Dominique
D
Peng
Philip
P
Banner
Robert
R
Barton
Pamela M
PM
Boulanger
Aline
A
Clark
Alexander J
AJ
Gordon
Allan S
AS
Guerriere
Denise N
DN
Guertin
Marie-Claude
MC
Intrater
Howard M
HM
Lefort
Sandra M
SM
Lynch
Mary E
ME
Moulin
Dwight E
DE
Ong-Lam
May
M
Racine
Mélanie
M
Rashiq
Saifee
S
Shir
Yoram
Y
Taenzer
Paul
P
Ware
Mark
M
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D018710:Pain Clinics / Q000706:statistics & numerical data*; D059408:Pain Management; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology; D013405:Suicide / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014850:Waiting Lists; D055815:Young Adult