title: Outcomes of follow-up visits to chronic nonmalignant pain patients.
abstract: Follow-up visits by clinical nurse specialists are beneficial for patients with various chronic conditions. It is unknown whether patients with chronic nonmalignant pain can achieve similar benefit. The aim of this study was to assess outcomes of follow-up visits by clinical nurse specialists to chronic nonmalignant pain patients regarding health-related quality of life (HRQoL), pain, opioid treatment, quality of sleep, and depression. A total of 102 patients were enrolled in a prospective randomized controlled trial during a 2-year period after discharge from multidisciplinary pain treatment and randomized to intervention or control group. Intervention group patients (n = 52) received home visits every fourth month for 2 years. The findings showed that HRQoL improved generally more in the intervention group. Statistically significant improvements were observed for physical function and bodily pain. Whereas the intervention group maintained the pain level on a visual analog scale, the control group reported more pain. During the observation period, the control group increased dosage of opioids whereas the intervention group maintained stable dosage. No significant effect on quality of life was found. Nurses identified signs of depression in 80% of their patients scoring depression on the simultaneous depression questionnaire, and thereby could refer patients to early treatment. Follow-up visits by clinical nurse specialists appeared to offer positive benefits to patients with chronic nonmalignant pain after discharge from multidisciplinary pain treatment. The intervention improved physical functioning, reduced bodily pain and pain intensity and prevented opioid dosage increase. Most episodes of depression were identified and referred to relevant treatment.
authors.affiliation: Multidisciplinary Pain Center, University Hospital of Copenhagen, Copenhagen, Denmark. livfrich@rh.dk
authors.forename: Liv M H
authors.initials: LM
authors.lastname: Frich
authors.forename: Jan
authors.initials: J
authors.lastname: Sorensen
authors.forename: Susanne
authors.initials: S
authors.lastname: Jacobsen
authors.forename: Bente
authors.initials: B
authors.lastname: Fohlmann
authors.forename: Jette
authors.initials: J
authors.lastname: Højsted
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000451:nursing*; D003152:Community Health Nursing / Q000458:organization & administration*; D003863:Depression / Q000451:nursing; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018710:Pain Clinics / Q000458:organization & administration*; D015397:Program Evaluation; D011788:Quality of Life; D012890:Sleep; D013041:Specialties, Nursing / Q000458:organization & administration*; D011795:Surveys and Questionnaires