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

Abstract

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.

What Is the Effectiveness of Different Duration Interdisciplinary Treatment Programs in Patients with Chronic Pain? A Large-Scale Longitudinal Register Study

“…Importantly, although our results showed positive effects at a group level, data on our MCID indicated that around 20% of the patients deteriorated at least one MCID on the primary and secondary outcomes, and that is despite receiving IMPR. This is in line with recent findings from Vartiainen et al [ 43 ], who also showed that while health-related quality of life was improved in nearly half of the patients, there were also approx. 30% who reported a clinically important deterioration at 12-month follow-up after rehabilitation.…”

Multivariate correlations between pain, life interference, health-related quality of life and full-time sick leave 1 year after multimodal rehabilitation, focus on gender and age

“…More specifically, the results showed that low physical functioning, low health-related quality of life, high life interference and long duration of pain before MMRP seemed to affect women more than men in relation to sick leave 1 year after MMRP. This is in line with previous research that has shown that health-related quality of life [43] and physical disabilities [45] can have an impact on the possibility of a successful return to work.…”

“…These results indicate the urgency to offer early interventions to persons with chronic pain in need of multimodal rehabilitation. These findings should be viewed in light of previous research which has presented links between long pain duration and less positive treatment outcomes regarding health-related quality of life [43] as well as return to work, after multimodal pain rehabilitation [44].…”

Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain

“…In patients with chronic musculoskeletal pain, multidisciplinary or interdisciplinary pain rehabilitation either improved HRQOL, or it did not [ 10 , 11 , 12 , 13 , 14 ]. However, major improvement in HRQOL after pain rehabilitation programs positively associated with shorter duration of pain and worse baseline HRQOL [ 15 ]. Similarly, two years after participating in a pain program for patients with mixed chronic musculoskeletal pain, improvements in pain and function were maintained, health-care usage decreased, and the number of working hours increased [ 16 ].…”