title: Impact on health-related quality of life and costs of managing chronic neuropathic pain in academic pain centres: Results from a one-year prospective observational Canadian study.
abstract: BACKGROUND
  The management of chronic pain, including neuropathic pain (NeP), is a major public health issue. However, there is a paucity of data evaluating pain management strategies in real-life settings.
  
  
  OBJECTIVE
  To inform policy makers about the economic value of managing chronic NeP in academic centres by conducting a subeconomic assessment of a Canadian multicentre cohort study aimed at determining the long-term outcomes of the management of chronic NeP in academic pain centres. Specific questions regarding the economic value of this type of program were answered by a subset of patients to provide further information to policy makers.
  
  
  METHODS
  Baseline demographic information and several pain-related measurements were collected at baseline, three, six and 12 months in the main study. A resource use questionnaire aimed at determining NeP-related costs and the EuroQoL-5 Dimension were collected in the subset study from consenting patients. Statistical analyses were conducted to compare outcomes over time and according to responder status.
  
  
  RESULTS
  A total of 298 patients were evaluated in the present economic evaluation. The mean (± SD) age of the participants was 53.7±14.0 years, and 56% were female. At intake, the mean duration of NeP was >5 years. Statistically significant improvements in all pain and health-related quality of life outcomes were observed between the baseline and one-year visits. Use decreased over time for many health care resources (eg, visits to the emergency room decreased by one-half), which resulted in overall cost savings.
  
  
  CONCLUSIONS
  The results suggest that increased access to academic pain centres should be facilitated in Canada.
authors.forename: J E
authors.initials: JE
authors.lastname: Tarride
authors.forename: D E
authors.initials: DE
authors.lastname: Moulin
authors.forename: M
authors.initials: M
authors.lastname: Lynch
authors.forename: A J
authors.initials: AJ
authors.lastname: Clark
authors.forename: L
authors.initials: L
authors.lastname: Stitt
authors.forename: A
authors.initials: A
authors.lastname: Gordon
authors.forename: P K
authors.initials: PK
authors.lastname: Morley-Forster
authors.forename: H
authors.initials: H
authors.lastname: Nathan
authors.forename: C
authors.initials: C
authors.lastname: Smyth
authors.forename: C
authors.initials: C
authors.lastname: Toth
authors.forename: M A
authors.initials: MA
authors.lastname: Ware
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000191:economics / Q000523:psychology / Q000628:therapy; D059408:Pain Management / Q000191:economics* / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult