A Cost-Analysis of an Interdisciplinary Pediatric Chronic Pain Clinic

Mahrer, Nicole E.; Gold, Jeffrey I.; Luu, Michael; Herman, Patricia M.

doi:10.1016/j.jpain.2017.09.008

Cited by 37 publications

(41 citation statements)

References 22 publications

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“…The beneficial effects of MPM include reduced pain intensity, improved functioning and improved HRQoL (Becker et al, ; Dysvik, Kvaløy, Stokkeland, & Natvig, ; Heiskanen, Roine, & Kalso, ; Jensen, Turner, & Romano, ; Kamper et al, ). In pediatric patients, MPM has also been shown to reduce hospital visits and related costs (Mahrer, Gold, Luu, & Herman, ). However, many original studies and reviews have shown efficacy in selected patient groups only, and the quality of evidence is moderate at best (Kamper et al, ; Scascighini et al, ).…”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life change in patients treated at a multidisciplinary pain clinic

Vartiainen

Heiskanen

Sintonen

et al. 2019

European Journal of Pain

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Background Multidisciplinary pain management (MPM) is a generally accepted method for treating chronic pain, but heterogeneous outcome measures provide only limited conclusions concerning its effectiveness. Therefore, further studies on the effectiveness of MPM are needed to identify subgroups of patients who benefit, or do not benefit, from these interventions. Our aim was to analyse health‐related quality of life (HRQoL) changes after MPM and to identify factors associated with treatment outcomes. Methods We carried out a real world observational follow‐up study of chronic pain patients referred to a tertiary multidisciplinary outpatient pain clinic to describe, using the validated HRQoL instrument 15D, the HRQoL change after MPM and to identify factors associated with this change. 1,043 patients responded to the 15D HRQoL questionnaire at baseline and 12 months after the start of treatment. Background data were collected from the pre‐admission questionnaire of the pain clinic. Results Fifty‐three percent of the patients reported a clinically important improvement and, of these, 81% had a major improvement. Thirty‐five percent reported a clinically important deterioration, and 12% had no change in HRQoL. Binary logistic regression analysis revealed that major improvement was positively associated with shorter duration of pain (<3 years), worse baseline HRQoL, higher education levels and being employed. Conclusions The majority of the patients reported significant HRQoL improvement after multidisciplinary pain management. Better understanding of the factors associated with treatment outcomes is needed to meet the needs of those who had unfavourable outcomes. Significance Multidisciplinary pain management (MPM) increases the health‐related quality of life (HRQoL) in most patients. More research into factors associated with HRQoL change is needed to understand why not all patients benefit from MPM and how MPM approaches could be improved to meet the needs of these patients.

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Section: Introductionmentioning

confidence: 99%

Health‐related quality of life change in patients treated at a multidisciplinary pain clinic

Vartiainen

Heiskanen

Sintonen

et al. 2019

European Journal of Pain

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“…Intensive residential care is not a realistic model for all patients, 38 given the high costs to individuals and/or third parties. 39 However, combinations of these integrated approaches are likely necessary to achieve similar outcomes. 40,41 Further research is needed to help determine which treatments, at what intensities, and for what durations, are necessary to achieve satisfactory outcomes in terms of chronic pain and co-occurring mood and substance use to expand access and reduce costs and life disruption associated with treatment.…”

Section: Discussionmentioning

confidence: 99%

<p>Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital</p>

Buono

Savage

Cerrito³

et al. 2020

JPR

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The objective is to report outcomes of an interdisciplinary group-based residential chronic pain recovery program (CPRC), located in a private non-profit psychiatric hospital. The chronic pain program was aimed at treatment and engagement in self-care of both pain and co-occurring disorders in a residential facility that also offered treatment for specific psychiatric disorders. Patients and Methods: A retrospective chart review was conducted that included a convenience sample of 131 patients admitted from March 2012 through August 2017 who completed treatment. An interdisciplinary team of professionals provided psychobehavioral therapy, movement therapies and medication management. Patients completed a battery of psycho-social and demographic questionnaires on admission and before discharge of the program. Results: Significant differences were noted in pain severity, pain interference, depression and anxiety (p<.01) between admission and discharge, and the Chronic Pain Coping Inventory demonstrated significant differences in guarding (p <.001), asking (p =.018), exercise (p <.001), relaxation (p <.001), and pacing (p=.024). Of patients using opioids on admission, at discharge, 37% had tapered and remained off all opioids, 43% were using buprenorphine for opioid use disorder, and 20% continued on analgesic opioids. Conclusion: Treatment was associated with reductions in pain severity and interference, in anxiety and in depression as well as improvements in pain coping. Additionally, there was a reduction in reliance on opioids for pain relief.

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“…Comprehensive pain care strategies include not only implementation of effective modalities but also aim to maximize their benefit through optimal combinations and bundling of care. 15 , 68 – 70 …”

Section: Objective: Our Proposed Innovationmentioning

confidence: 99%

Group Acupuncture Therapy With Yoga Therapy for Chronic Neck, Low Back, and Osteoarthritis Pain in Safety Net Setting for an Underserved Population: Design and Rationale for a Feasibility Pilot

Nielsen

Teets

Moonaz

et al. 2020

Glob Adv Health Med

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Chronic pain is prevalent in the United States, with impact on physical and psychological functioning as well as lost work productivity. Minority and lower socioeconomic populations have increased prevalence of chronic pain with less access to pain care, poorer outcomes, and higher risk of fatal opioid overdose. Acupuncture therapy is effective in treating chronic pain conditions including chronic low back pain, neck pain, shoulder pain, and knee pain from osteoarthritis. Acupuncture therapy, including group acupuncture, is feasible and effective, and specifically so for underserved and diverse populations at risk for health outcome disparities. Acupuncture therapy also encourages patient engagement and activation. As chronic pain improves, there is a natural progression to want and need to increase activity and movement recovery. Diverse movement approaches are important for improving range of motion, maintaining gains, strengthening, and promoting patient engagement and activation. Yoga therapy is an active therapy with proven benefit in musculoskeletal pain disorders and pain associated disability. The aim of this quasi-experimental pilot feasibility trial is to test the bundling of these 2 effective care options for chronic pain, to inform both the design for a larger randomized pragmatic effectiveness trial as well as implementation strategies across underserved settings.

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A Cost-Analysis of an Interdisciplinary Pediatric Chronic Pain Clinic

Cited by 37 publications

References 22 publications

Health‐related quality of life change in patients treated at a multidisciplinary pain clinic

Health‐related quality of life change in patients treated at a multidisciplinary pain clinic

<p>Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital</p>

Group Acupuncture Therapy With Yoga Therapy for Chronic Neck, Low Back, and Osteoarthritis Pain in Safety Net Setting for an Underserved Population: Design and Rationale for a Feasibility Pilot

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