title: Short-term outcomes of patients being treated for chronic intractable pain at a liaison clinic and exacerbating factors of prolonged pain after treatment.
abstract: BACKGROUND
  Although a multidisciplinary approach is often recommended to treat intractable pain, this approach does not completely prevent uncontrolled pain in some patients. The aim of this retrospective study was to investigate the exacerbating factors of prolonged, intractable pain among patients being treated at a pain liaison clinic.
  
  
  METHODS
  The participants of this study were 94 outpatients (32 men, 62 women) with chronic intractable pain who visited our hospital between April 2013 and February 2015. Demographic and clinical information was obtained from all patients at baseline. Experts in various fields, including anesthesia, orthopedic surgery, psychiatry, physical therapy, and nursing, were involved in the treatment procedures. All patients were assessed before and after a 6-month treatment period using the following measures: the Numeric Rating Scale (NRS); the Pain Catastrophizing Scale (PCS); the Hospital Anxiety and Depression Scale (HADS); the Pain Disability Assessment Scale (PDAS); and the Oswestry Disability Index (ODI). All participants were then divided into two groups based on their self-reported pain after treatment: a pain relief group (n = 70) and a prolonged pain group (n = 24). The exacerbating factors of prolonged pain after treatment in the pain liaison outpatient clinic were analyzed using univariate and multiple logistic regression analysis.
  
  
  RESULTS
  A significant improvement in NRS scores was observed after the 6-month follow-up period. After treatment, 24 (25.5%) of the 94 patients reported having prolonged pain. Significant improvements were seen in the PCS, PDAS, and ODI scores in the pain relief group, and in the HADS depression scores in the prolonged pain group. On univariate and multiple regression analysis, HADS depression scores were identified as a factor related to prolonged pain after treatment.
  
  
  CONCLUSIONS
  The results of the present study suggest that severe depression at the initial visit to the liaison outpatient clinic was an exacerbating factor for prolonged pain after treatment.
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tetsunaga
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan. Electronic address: tomonori_t31@yahoo.co.jp.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Tetsunaga
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nishida
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Sugimoto
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takigawa
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama 700-8558, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D000072700:Conservative Treatment / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010045:Outpatients; D018710:Pain Clinics; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010148:Intractable Pain / Q000175:diagnosis / Q000628:therapy*; D026741:Physical Therapy Modalities; D012008:Recurrence; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics