Attrition from a pain management programme

Coughlan, Gareth; Ridout, Kate; Williams, Amanda C de C; Richardson, Phil

doi:10.1111/j.2044-8260.1995.tb01481.x

Cited by 50 publications

(56 citation statements)

References 18 publications

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“…Unlike most reported PMP studies which have offered inpatient programmes (Coughlan et al, 1995;Johansson et al, 1998;Morley et al, 1999;Vlaeyen et al, 1995a), this was an outpatient PMP. Patients had the choice to attend the weekly sessions and were probably less motivated to attend the session if domestic or social diffi culties arose during the training period, and even less so if they were follow-up meetings.…”

Section: Discussioncontrasting

confidence: 56%

Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital

Wong

Rietzschel

Mulherin

et al. 2008

Musculoskeletal Care

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Section: Discussioncontrasting

confidence: 56%

Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital

Wong

Rietzschel

Mulherin

et al. 2008

Musculoskeletal Care

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“…Scores <30 have been shown to be indicative of less sustainable treatment gains and predictive of a lower rate of return to work and/or maintenance of treatment gains. 28 …”

Section: Pain and Pain-related Measuresmentioning

confidence: 99%

Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

Nielsen¹,

Campbell²,

Peacock

et al. 2016

Aust. Health Review

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Objective. The aims of the present study were to describe the use, and barriers to the use, of non-medication pain therapies and to identify the demographic and clinical correlates of different non-opioid pain treatments.Methods. The study was performed on a cohort (n = 1514) of people prescribed pharmaceutical opioids for chronic noncancer pain (CNCP). Participants reported lifetime and past month use of healthcare services, mental and physical health, pain characteristics, current oral morphine equivalent daily doses and financial and access barriers to healthcare services.Results. Participants reported the use of non-opioid pain treatments, both before and after commencing opioid therapy. Services accessed most in the past month were complementary and alternative medicines (CAMs; 41%), physiotherapy (16%) and medical and/or pain specialists (15%). Higher opioid dose was associated with increased financial and access barriers to non-opioid treatment. Multivariate analyses indicated being younger, female and having private health insurance were the factors most commonly associated with accessing non-opioid treatments.Conclusions. Patients on long-term opioid therapy report using multiple types of pain treatments. High rates of CAM use are concerning given limited evidence of efficacy for some therapies and the low-income status of most people with CNCP. Financial and insurance barriers highlight the importance of considering how different types of treatments are paid for and subsidised.What is known about the topic? Given concerns regarding long-term efficacy, adverse side-effects and risk of misuse and dependence, prescribing guidelines recommend caution in prescribing pharmaceutical opioids in cases of CNCP, typically advising a multidisciplinary approach to treatment. There is a range of evidence supporting different (non-drug) treatment approaches for CNCP to reduce pain severity and increase functioning. However, little is known about the non-opioid treatments used among those with CNCP and the demographic and clinical characteristics that may be associated with the use HEALTH SERVICE RESEARCH of different types of treatments. Understanding the use of non-drug therapy among people with CNCP is crucial given the potential to improve pain control for these patients. What does this paper add? The present study found that a wide range of non-opioid treatments was accessed by the study sample, both before and after commencing opioids, indicating that in this sample opioids were not the sole strategy used for pain management. The most common treatment (other than opioids) was CAM, reported by two-fifths of the sample. Having private health insurance was associated with increased use of non-opioid treatments for pain, highlighting the importance of considering how treatments are paid for and potential financial barriers to effective treatments. What are the implications for practitioners? Patients' beliefs and financial barriers may affect the uptake of different treatments. Many patients may be using com...

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“…Arnstein et al (1999) observed that self-efficacy beliefs (related to pain management, coping and physical functioning) mediated pain intensity and disability, and that both self-efficacy beliefs and pain intensity contributed to depression. Other research suggests that drop-out from a pain management program is more likely when self-efficacy beliefs are not improved by treatment (Coughlan et al, 1995). Nicholas (1989) developed a measure of functioning despite pain in order to assess normal functioning (well behavior) rather than pain management (illness behavior) with the idea that this approach is conceptually more consistent with Bandura's emphasis on persistence in the face of obstacles and aversive experiences, and that improved functioning might be a more realistic outcome to target than pain relief.…”

Section: Introductionmentioning

confidence: 99%

Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions)

Bursch

Tsao

Meldrum

et al. 2006

Pain

101

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Despite frequent targeting of health beliefs in pediatric chronic pain treatment interventions, there are currently no reliable and valid self-efficacy measures for children with chronic pain and their parents. The current study examined the psychometric properties of parent and child versions of a self-efficacy measure related to the child functioning normally when in pain. Pediatric pain patients, 9-18 years of age, and a caregiver completed questionnaires before an initial tertiary care clinic appointment. The 67 patients in our sample had an average of 1.7 pain locations, including abdominal pain (43.3%), headaches (50.7%), body pain (25.4%), back pain (23.9%), limb pain (20.9%), and/or chest pain (9.0%). Reliability for the new measures was excellent; the Cronbach's alpha was .89 for the 7 child items and .90 for the 7 parent items. Strong evidence for construct validity was also obtained as 23 of the 27 hypothesized correlations were confirmed. As predicted, parent and child ratings of increased self-efficacy for the child functioning normally when in pain were significantly correlated with each other, and to parent reports of fewer problems functioning due to physical or emotional problems; parent reports of fewer somatic, behavioral or emotional symptoms; parent reports of increased self-esteem, and unrelated to child pain, age and gender. Additionally, child ratings of increased self-efficacy were significantly correlated with child reports of increased selfesteem and fewer somatic symptoms. Replication with a larger sample size, more complex modeling, and prospective studies are indicated.

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Attrition from a pain management programme

Cited by 50 publications

References 18 publications

Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital

Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital

Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions)

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