title: Efficacy and cost-effectiveness: A study of different treatment approaches in a tertiary pain centre.
abstract: BACKGROUND
  Chronic pain is considered to be a complex phenomenon, involving an interrelation of biological, psychosocial and sociocultural factors. Currently, no single treatment or therapy can address all aspects of this pathology. In our expert tertiary pain centre, we decide to assess the effectiveness of four treatments for chronic pain classically proposed in our daily clinical work: physiotherapy; psycho-education; physiotherapy combined with psycho-education; and self-hypnosis/self-care learning.
  
  
  METHODS
  This study included 527 chronic pain patients, with a mean duration of pain of 10 years. Patients were allocated either to one of the four pre-cited treatment groups or to the control group. Pain intensity, quality of life, pain interference, anxiety and depression were assessed before and after treatment.
  
  
  RESULTS
  This study revealed a significant positive effect on pain interference and anxiety in patients included in the physiotherapy combined with psycho-education group, after 20 sessions spread over 9 months of treatment. The most prominent results were obtained for patients allocated to the self-hypnosis/self-care group, although they received only six sessions over a 9-month period. These patients showed significant benefits in the areas of pain intensity, pain interference, anxiety, depression and quality of life.
  
  
  CONCLUSIONS
  This clinical report demonstrates the relevance of biopsychosocial approaches in the improvement of pain and psychological factors in chronic pain patients. The study further reveals the larger impact of self-hypnosis/self-care learning treatment, in addition to a cost-effectiveness benefit of this treatment comparative to other interventions.
authors.affiliation: Algology-Palliative Care Department, University Hospital of Liège, University of Liège, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Vanhaudenhuyse
authors.affiliation: Department of Work Psychology, University of Liège, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Gillet
authors.affiliation: Algology-Palliative Care Department, University Hospital of Liège, University of Liège, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Malaise
authors.affiliation: Algology-Palliative Care Department, University Hospital of Liège, University of Liège, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Salamun
authors.affiliation: Department of Work Psychology, University of Liège, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Barsics
authors.affiliation: Department of Motricity Sciences, University Hospital of Liège, University of Liège, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Grosdent
authors.affiliation: Department of Motricity Sciences, University Hospital of Liège, University of Liège, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Maquet
authors.affiliation: Department of Work Psychology, University of Liège, Belgium.
authors.forename: A-S
authors.initials: AS
authors.lastname: Nyssen
authors.affiliation: Algology-Palliative Care Department, University Hospital of Liège, University of Liège, Belgium.
authors.forename: M-E
authors.initials: ME
authors.lastname: Faymonville
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000628:therapy*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics / Q000706:statistics & numerical data; D059408:Pain Management / Q000379:methods* / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome