Characteristics and complexity of chronic pain patients referred to a community-based multidisciplinary chronic pain clinic

Abstract

Background: Community-based care fills an important service gap for patients living with chronic pain. Better understanding of unmet patient needs in the community may inform improved policy and resource allocation. Aims: The aim of this study was to describe patients presenting to a community-based, multidisciplinary chronic pain clinic in Vancouver, British Columbia. Methods: This is a retrospective cross-sectional study of 935 unique consecutive patients who completed an intake questionnaire between January 2016 and March 2017. All data were patient reported. Results: Nine hundred thirty-five patient records were analyzed for descriptive characteristics. The mean age of the population was 49.5 (SD = 14.9) years; 70% were female. Approximately 50% of patients lived below the poverty line in Vancouver; 30% were not working due to disability, 51% had pain for more than 5 years, and 63% reported severe functional impairment. Conclusions: Substantial unmet need is demonstrated in this patient population accessing a community-based chronic pain clinic. The population described is mainly of working age with significant functional impairment, reflecting a high level of need due to severity and duration of symptoms, poverty, and other characteristics described. RÉSUMÉ Contexte: Les soins communautaires comblent une lacune importante pour les patients qui souffrent de douleur chronique. Une meilleure compréhension des besoins des patients qui ne sont pas comblés au sein de la communauté pourrait permettre d'améliorer les politiques et l'allocation des ressources. But: Décrire les patients qui se présentent dans une clinique communautaire multidisciplinaire de douleur chronique à Vancouver, Colombie-Britannique (C.-B.). Méthodes: Étude transversale rétrospective de 935 patients uniques consécutifs qui ont répondu à un questionnaire d'admission entre janvier 2016 et mars 2017. Toutes les données étaient déclarées par les patients. Résultats: Les dossiers de 935 patients ont été analysés afin d'en tirer les caractéristiques descriptives. L'âge moyen de la population était de 49,5 ans (É.-C. 14,9) et 70 % étaient des femmes. Approximativement 50 % des patients vivaient sous le seuil de pauvreté à Vancouver, C.-B.; 30 % ne travaillaient pas en raison d'une incapacité, 51 % avaient de la douleur depuis plus de cinq ans et 63 % ont fait état d'une déficience fonctionnelle grave. Conclusions: Des besoins considérables demeurent non comblés au sein de cette population de patients ayant recours à une Clinique communautaire de douleur chronique. La population décrite est principalement en âge de travailler, ce qui démontre un niveau élevé de besoins en raison de la gravité et de la durée des symptômes, de la pauvreté et d'autres caractéristiques décrites.

Pilot Trial of the Reboot Online Program: An Internet-Delivered, Multidisciplinary Pain Management Program for Chronic Pain

“…However, the current sample differed to the existing literature regarding the percentage of employed participants, with more participants actively employed in the previously reported literature (range: 30.4%–67%), compared to the current sample (25%) [ 47 , 48 ]. In addition, the gender distribution was not comparable, with previous literature typically reporting fewer female participants (range: 57.4%–71.1%) than the current sample (95%); however, given the small sample size, caution should be used in making conclusions about the influence of the gender distribution on the present results [ 47 , 48 ]. Therefore, the demographic characteristics and baseline scores on several of the primary and secondary outcome measures are comparable to participants accessing other online pain programs and face-to-face multidisciplinary pain clinics.…”

“…The baseline scores of the current sample on several questionnaires (DASS-D; DASS-A; DASS-S; PHQ-9; PSEQ; TSK) were comparable to those reported by participants accessing Australian and Canadian face-to-face multidisciplinary pain clinics [ 47 , 48 ]. However, the current sample differed to the existing literature regarding the percentage of employed participants, with more participants actively employed in the previously reported literature (range: 30.4%–67%), compared to the current sample (25%) [ 47 , 48 ]. In addition, the gender distribution was not comparable, with previous literature typically reporting fewer female participants (range: 57.4%–71.1%) than the current sample (95%); however, given the small sample size, caution should be used in making conclusions about the influence of the gender distribution on the present results [ 47 , 48 ].…”

“…The demographic characteristics of the current sample are similar in terms of the average age and duration of pain compared with reported participant demographics from online pain management programs and face-to-face multi-disciplinary pain management clinics [ 14 , 47 , 48 ]. The baseline scores of the current sample on several questionnaires (DASS-D; DASS-A; DASS-S; PHQ-9; PSEQ; TSK) were comparable to those reported by participants accessing Australian and Canadian face-to-face multidisciplinary pain clinics [ 47 , 48 ]. However, the current sample differed to the existing literature regarding the percentage of employed participants, with more participants actively employed in the previously reported literature (range: 30.4%–67%), compared to the current sample (25%) [ 47 , 48 ].…”

Evaluating the Relationship between Well-Being and Living with a Dog for People with Chronic Low Back Pain: A Feasibility Study

“…One possible explanation for this lower than anticipated response could be related to the high level of pain and disability in the sample. Characteristics of patients attending chronic pain programs include poverty, financial stress, severe functional disability and past or current medical conditions [71]. We observed high scores for disability and the fact that questionnaires continued to be returned over a five-month period.…”

Pain Relief as a Motivation for Cannabis Use Among Young Adult Users With and Without Chronic Pain

“…Pain characteristics reported by the chronic pain group, regardless of interference level, were generally commensurate with those observed in pain specialty clinics, including moderateto-severe intensity pain, endorsement of multiple pain sites, and elevated pain-related negative affect. 28 The rate of chronic pain in this sample of young adults is remarkable given that pain populations and medicinal dispensaries were not targeted during recruitment and study advertisements emphasized health and wellness, not pain. These preliminary findings suggest that young adult cannabis users may be a useful target for psychosocial pain prevention and intervention programs, particularly if larger scale studies affirm that pain is overrepresented in this group.…”