Multidisciplinary Allocation of Pain Treatment: Long-Term Outcome and Correlates of Cognitive-Behavioral Processes

Abstract

Objective: To investigate the long-term effects of multidisciplinary allocation of pain treatment on pain intensity, functional disability, depression, and medication use in outpatients with chronic pain, and to identify cognitive-behavioral predictors [worrying, avoidance behavior, fear of pain, helplessness, and acceptance] of the primary outcome measures.

Methods: Eighty-six outpatients with chronic pain who were treated at a multidisciplinary pain center completed various questionnaires and a pain diary one week before treatment started, and 3 and 12 months later.

Results: Functional disability and depression improved significantly 12 months after the start of treatment in comparison with before treatment. The decrease in scores for the cognitive-behavioral variables worrying, fear of pain, helplessness, and avoidance behavior at three months was associated with the decrease in functional disability and depression at 12 months.

Conclusion: Patients with chronic pain may benefit in the long term from multidisciplinary allocation to pain treatment with respect to functional disability and depression. Changes of cognitive-behavioral processes seem to contribute to achieving long-term effects of multidisciplinary allocation of pain treatment. There is a need for high quality clinical trials in this field in order to clarify the specific contribution of cognitive-behavioral process variables.

KEYWORDS:

• Chronic pain
• follow-up
• long-term outcome
• multidisciplinary
• cognitivebehavioral predictors