Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions

Abstract

Purpose: To measure the effect of 4 weeks traditional multidisciplinary pain management program (TMP) versus neuroscience education and mindfulness-based cognitive therapy (NEM) on quality of life (HRQL) among women with chronic pain. Method: This observational longitudinal cohort study conducted in an Icelandic rehabilitation centre included 122 women who received TMP, 90 receiving NEM, and 57 waiting list controls. Pain intensity (visual analogue scale) and HRQL (Icelandic Quality of Life scale) were measured before and after interventions. ANOVA and linear regression were used for comparisons. Results: Compared with controls we observed statistically significant changes in pain intensity (p < 0.001) and HRQL (p < 0.001) among women receiving both interventions, while NEM participants reported significant improvements in sleep (8.0 versus 4.4 in TMP; p = 0.008). Head to head comparison between study groups revealed that pain intensity improved more among TMP participants (21.8 versus 17.2 mm; p = 0.013 adjusted). Women with low HRQL at baseline improved more than those with higher HRQL (mean TMP = 13.4; NEM = 12.9 if HRQL ≤ 35 versus mean TMP = 6.6 and NEM = 7.8 if HQRL > 35). Conclusions: Our non-randomized study suggests that both NEM and TMP programs improve pain and HRQL among women with chronic pain. Sleep quality showed more improvements in NEM while pain intensity in TMP. Longer-term follow-ups are needed to address whether improvements sustain.

Implications for Rehabilitation

• Chronic pain is a debilitating condition affecting quality of life and restricting societal participation.

• Intensive multidisciplinary bio-psycho-social rehabilitation is essential for this patient group.

• This study shows improvement in health-related quality of life and pain intensity following such rehabilitation.

• Emphasizing mindfulness based cognitive therapy and neuroscience patient education improves sleep to more extend than more traditional approach.

• Chronic pain
• health-related quality of life
• mindfulness
• multidisciplinary rehabilitation
• neuroscience patient education

Acknowledgements

We thank the HNLFÍ rehabilitation clinic for participation in the study and access to data. Special thanks to all team members in the pain department from 2001 to 2009 as well as patients enrolled in the two programs. We thank Professor Patty Solomon for assistance in preparing this manuscript.

Declaration of interest

The authors report no declarations of interest. This study was granted by the Association of Icelandic Physical Therapists and from the Lifelong Learning Centre in Southern Iceland. The funding sources had no role in data acquisition, analysis or manuscript preparation.