Establishment of a liaison clinic for patients with intractable chronic pain

Tetsunaga, Tomoko; Tetsunaga, Tomonori; Nishie, Hiroyuki; Ozaki, Toshifumi

doi:10.1007/s00776-015-0748-y

Cited by 13 publications

(15 citation statements)

References 23 publications

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“…Our previous report also focused on PCS [25] for assessing pain catastrophizing, which initiates a vicious pain spiral in the fear-avoidance model. In the present study, PSEQ and PCS scores were independent factors in patients with intractable chronic pain, indicating that self-efficacy and pain catastrophizing may coexist independently.…”

Section: Discussionmentioning

confidence: 99%

The factors driving self-efficacy in intractable chronic pain patients: a retrospective study

et al. 2019

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BackgroundThe fear-avoidance model is a theoretical paradigm for explaining acute and chronic pain. In this model, pain catastrophizing plays an important role. On the other hand, self-efficacy influences whether patients view their pain optimistically, ultimately preventing the conversion of pain into intractable pain. The aim of the present study was to evaluate the factors that influence self-efficacy in patients with chronic pain.MethodsStudy participants included 147 outpatients (35 men, 112 women) with intractable chronic pain who visited our hospital between September 2014 and July 2015. Their mean age was 71.0 (range 32–92) years. Pain sites were as follows: low back, 97 patients; knee, 71 patients; shoulder, 34 patients; and hip, 15 patients. All patients were assessed using the following measures: Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and Pain Self-Efficacy Questionnaire (PSEQ). All participants were further divided into two groups based on median PSEQ scores (group L: PSEQ of 35 points or less, n = 74; group H: PSEQ greater than 35 points, n = 73). The factors that influenced self-efficacy in these patients were analyzed using univariate and multiple linear regression analyses.ResultsSignificant differences were observed in gender; pain duration; and NRS, PDAS, HADS, and PCS scores between group L and group H. Multiple linear regression analysis revealed that self-efficacy was correlated with PDAS score, HADS depression score, and pain duration.ConclusionsPatients with longer pain duration indicated greater self-efficacy and patients with higher pain disability and depression exhibited lower self-efficacy.

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Section: Discussionmentioning

confidence: 99%

The factors driving self-efficacy in intractable chronic pain patients: a retrospective study

et al. 2019

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“…Formal liaisons between general practitioners and specialists have been demonstrated to improve functional outcomes in chronically mentally ill patients [ 41 ]. A liaison clinic for patients with intractable chronic pain was able to improve patient catastrophizing and anxiety [ 42 ]. The results of this study suggest that the multidisciplinary intervention may be effective in treating anxiety, pain disability, and pain catastrophizing.…”

Section: Discussionmentioning

confidence: 99%

Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain

Tetsunaga

Tanaka

et al. 2016

Pain Research and Management

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Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment. Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief. Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP.

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“…A recent study reported that patients treated for chronic intractable pain at a pain liaison clinic showed significant improvement in pain catastrophizing and anxiety after 6 months of treatment. [ 28 ] We also believe that drug dependence is “a family illness,” as a patient's family plays a crucial role in recovery because the drug dependent patients lack insight into their disease. Therefore, cognitive behavioral therapy with the patients’ families has been recommended.…”

Section: Discussionmentioning

confidence: 99%

Drug dependence in patients with chronic pain

et al. 2018

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Drug dependence, which can exist concurrently with chronic pain, is seen as one of the major causes of rapidly increasing medical expenses. However, drug dependence in patients with chronic pain has not been evaluated. The aim of this study was to identify the risk factors for drug dependence in patients with chronic noncancer pain.This retrospective study included 151 patients with chronic noncancer pain (43 males, 108 females; mean age, 72 years). Low back pain (LBP) occurred in 96 patients, whereas 22 had shoulder pain, 8 had hip pain, and 77 had knee pain. Patients were divided into drug dependence and nondrug dependence groups based on the Severity of Dependence Scale (SDS) scores. Patients with SDS scores ≥5 and <5 were classified into drug dependence and nondrug dependence groups, respectively. All patients completed self-report questionnaires. Factors that predict drug dependence were identified by performing univariate and multivariate analyses.Sixty (40%) of the 151 patients met the SDS criteria for drug dependence. Significant differences were found between patients with and without drug dependence for the LBP, hip pain, number of medications, and for the Numerical Rating Scale, Pain Disability Assessment Scale (PDAS), Hospital Anxiety and Depression Scale, and Pain Catastrophizing Scale (PCS) scores. Multiple regression analysis identified LBP, hip pain, PCS, and PDAS scores as factors related to drug dependence in patients with chronic noncancer pain.Drug dependence tends to differ in patients based on the location of their chronic pain. Pain catastrophizing and disability indicated a greater tendency for drug dependence. Thus, PCS and PDAS scores are useful screening tools for predicting drug dependence in patients with chronic pain.

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Establishment of a liaison clinic for patients with intractable chronic pain

Cited by 13 publications

References 23 publications

The factors driving self-efficacy in intractable chronic pain patients: a retrospective study

The factors driving self-efficacy in intractable chronic pain patients: a retrospective study

Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain

Drug dependence in patients with chronic pain

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