Surgeon identification of pain catastrophizing versus the Pain Catastrophizing Scale in orthopedic patients after routine surgical consultation

Sabo, Marlis T.; Roy, Mili

doi:10.1503/cjs.009918

Cited by 10 publications

(13 citation statements)

References 15 publications

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“…Both groups reported less anger symptoms compared to the U.S. general population. Pain catastrophizing scale (PCS) scores were much lower in both groups than those previously reported for orthopedic patients [22] .…”

Section: Resultscontrasting

confidence: 55%

Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial

et al. 2020

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Background Postoperative opioid use can lead to chronic use and misuse. Few studies have examined effective approaches to taper postoperative opioid use while maintaining adequate analgesia. Methods This randomized, assessor-blinded, pilot trial of postoperative motivational interviewing and guided opioid tapering support (MI-Opioid Taper) added to usual care (UC) enrolled patients undergoing total hip or knee arthroplasty at a single U.S. academic medical center. MI-Opioid Taper involved weekly (to seven weeks) and monthly (to one year) phone calls until patient-reported opioid cessation. Opioid tapering involved 25% weekly dose reductions. The primary feasibility outcome was study completion in the group to which participants were randomized. The primary efficacy outcome, time to baseline opioid use, was the first of five consecutive days of return to baseline preoperative dose. Intention-to-treat analysis with Cox proportional hazards regression was adjusted for operation. ClinicalTrials.gov registration: NCT02070003. Findings From November 26, 2014, to April 27, 2018, 209 patients were screened, and 104 patients were assigned to receive MI-Opioid Taper (49 patients) or UC only (55 patients). Study completion after randomization was similar between groups (96.4%, 53 patients receiving UC, 91.8%, 45 patients receiving MI-Opioid Taper). Patients receiving MI-Opioid Taper had a 62% increase in the rate of return to baseline opioid use after surgery (HR 1.62; 95%CI 1.06–2.46; p = 0•03). No trial-related adverse events occurred. Interpretation In patients undergoing total joint arthroplasty, MI-Opioid Taper is feasible and future research is needed to establish the efficacy of MI-Opioid Taper to promote postoperative opioid cessation. Funding National Institute on Drug Abuse

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Section: Resultscontrasting

confidence: 55%

Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial

et al. 2020

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“…Since we began our study, another was published that showed physicians are not good at predicting a patient’s degree of catastrophization. 19 It is important to recognize that, despite some patients having factors that might be perceived by surgeons as predictors of a poor outcome (catastrophizing and LR), these patients showed significantly improved outcomes similar to the general population following CTR surgery. Surgeons should therefore be cautious when using subjective judgments to predict patient outcomes, particularly in a surgery that has uniformly good outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Patient Resilience and Catastrophizing on Carpal Tunnel Surgical Outcomes

McLaren¹,

Sims²,

Cheng³

et al. 2021

Journal of Hand Surgery Global Online

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Purpose: Outcomes following carpal tunnel release (CTR) are generally favorable. When patient satisfaction or symptom resolution is not as expected, understanding what factors contribute to that outcome could allow for strategies targeted at improving results. Our purpose was to determine if measurable mental health factors, specifically resilience and pain catastrophization, correlate with patients' postoperative outcomes following CTR. Methods: A prospective cohort study was performed. Ninety-four patients were recruited to take part in the study. Patients completed written consent, the Boston Carpal Tunnel Questionnaire (BCTQ), the Pain Catastrophizing Scale, and the Brief Resilience Scale. A single surgeon, or his resident under supervision, performed an open CTR under local anesthetic. Our primary outcome measure was a repeat BCTQ at 6 months. Pearson correlation coefficients and univariate analyses were performed to assess the correlation between Pain Catastrophizing Scale and Brief Resilience Scale scores and final BCTQ scores. Results: Forty-three and 63 participants completed the BCTQ at 3 and 6 months, respectively. This was 10% below the number needed to achieve appropriate power. Among those that responded, all participants showed improvement in their symptoms (P ¼ .001). There was no correlation between patients' Pain Catastrophizing Scale or Brief Resilience Scale scores and 6-month BCTQ scores or the amount of improvement in the BCTQ at final follow-up. Conclusions: Most participants improved following CTR. Patients' self-assessed resilience, and the degree of pain catastrophization did no correlate with the amount of improvement patients had after surgery. Type of study/level of evidence: Prognostic II.

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“…Another goal was to find a clinically relevant cut-off point which might help us identify a risk group in terms of pain catastrophizing. Previously in the literature, researchers used the 50 th (20 points) (Sullivan et al, 2005;Wideman et al, 2009) or 75 th (30 points) (Chibnall and Tait, 2009;Sabo and Roy, 2019;Sullivan et al,1995Sullivan et al, , 2001 percentiles of the PCS. Scott (Scott et al, 2014) used a receiver operating characteristic (ROC) curve analyses and identified 24 as the clinically meaningful score on the PCS.…”

Section: Discussionmentioning

confidence: 99%

“…However, determining the clinically relevant score is not easy as the cut-off values used in studies have varied greatly. Some studies (Chibnall and Tait, 2009;Sabo and Roy, 2019) have used 30 points suggested by the manual of PCS (Sullivan, n.d.) that was based on the distribution of PCS scores. The cut-off was established as the 75 th percentile of the distribution among patients with soft tissue back injury.…”

Section: Introductionmentioning

confidence: 99%

A bifactor structural model of the Hungarian Pain Catastrophizing Scale and latent classes of a clinical sample

Galambos

Stoll

Bolczár

et al. 2021

Heliyon

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Pain catastrophizing is an exaggerated cognitive-affective response to actual or anticipated pain, usually measured by the Pain Catastrophizing Scale (PCS). Our study aimed to test the bifactor measurement model of the Hungarian PCS and to identify a catastrophizing risk group with a clinically meaningful cut-off score.The data of 404 chronic spine-related (neck, back and low-back) pain patients (mean age: 58.61 (SD ¼ 14.34)) were used in our cross-sectional study. Besides pain-related and demographic data, pain catastrophizing and depressive symptoms were measured with questionnaires. Confirmatory factor analyses confirmed that the bifactor model outperformed the other tested measurement models, and the general catastrophizing factor was responsible for 81.5% of the explained variance. Using latent class analysis, we found that even moderately elevated pain catastrophizing score was related to more depressive symptoms and higher perceived pain intensity, and 22 score could be used as a cut-off score. Our results support the concept of global pain catastrophizing and the validity of the Hungarian PCS. Further studies are needed to evaluate the bifactor structure of this scale and the predictive value of the proposed cut-off score.

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Surgeon identification of pain catastrophizing versus the Pain Catastrophizing Scale in orthopedic patients after routine surgical consultation

Cited by 10 publications

References 15 publications

Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial

Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial

The Effects of Patient Resilience and Catastrophizing on Carpal Tunnel Surgical Outcomes

A bifactor structural model of the Hungarian Pain Catastrophizing Scale and latent classes of a clinical sample

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