Preliminary Outcomes from an Intensive Multidisciplinary Pain Program in a Veteran’s Administration Hospital: A Pilot Study

Abstract

Chronic pain is a leading cause of lost productivity, disability payments, and health care utilization among the Veteran population. As such, there is interest in chronic pain treatments that address not only physical functioning and pain, but also psychological functioning and pain-related beliefs. One such treatment that has been explored is multidisciplinary team treatments. This pilot study aimed to determine whether a multidisciplinary treatment program for chronic pain would be effective in a sample of primarily rural-based Veterans. Seventy Veterans completed multidisciplinary chronic pain treatment, which consisted of 3–5 hours of pain related services per week for twelve weeks with providers from seven different disciplines. Veterans took standardized pre- and post-test measures of functioning, pain, pain-related beliefs, and mood. The program was highly acceptable and feasible to both Veterans and medical providers. Participants reported statistically significant improvements in average pain level following the intervention and improvements in pain related beliefs, pain-related catastrophizing, pain-related self-efficacy, mood symptoms and increased activity engagement. The program was highly acceptable to participants and feasible to a rural VA medical center, as evidenced by high completion rates. Future research is needed for cost-benefit analysis of the multidisciplinary program compared to less time-intensive pain related services (e.g. CBT-CP), post-intervention pain-related health care utilization, and the role of pain-related beliefs in treatment outcomes.

Keywords:

• Chronic pain
• CBT-CP
• multidisciplinary treatment
• multidisciplinary pain treatment
• back pain
• pain-related self-efficacy
• pain-related catastrophizing
• Veterans
• pain-related mood symptoms
• pain education

Acknowledgements

This research is supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, The VISN 17 Center of Excellence for Research on Returning War Veterans and Doris Miller VA Hospital.

Disclaimer

The views expressed are solely those of the authors and do not reflect the official policy or position of the Veterans Administration, US Army, US Navy, US Air Force, the Department of Defense, or the US Government.

Declarations

Ethics approval and consent to participate

This work received approval from the University of Missouri IRB and the Truman VA Office of Research and Development. Informed consent was collected from all participants who completed the treatment protocol. This study utilized archival data, thus a waiver of consent was approved by the University of Missouri IRB and the Truman VA Office of Research and Development.

Consent for publication

This is not applicable to this study.

Availability of data and materials

The datasets analyzed in the current study are not publicly available due to institutional restrictions. However, de-identified raw data may be available from the corresponding author upon reasonable request, provided institutional IRB approval is granted.

Competing interests

The authors declare that they have no competing interests.

Funding

The authors report no funding was received for this study.

Authors’ contributions

RR, CK, NM, JM, and CS all participated in primary data collection. TA and RR participated in the statistical analysis of study data. TA and CH prepared and wrote the study manuscript. All authors read and approved of the final manuscript before submission.