Predictors of Responsivity to Interdisciplinary Pain Management

Day, Melissa A, Brinums, Melissa, Craig, Nathan, Geffen, Laurence, Geffen, Saul, Lovai, Miriam and Geffen, Gina (2017) Predictors of Responsivity to Interdisciplinary Pain Management. Pain medicine (Malden, Mass.), . doi:10.1093/pm/pnx169

Author Day, Melissa A
Brinums, Melissa
Craig, Nathan
Geffen, Laurence
Geffen, Saul
Lovai, Miriam
Geffen, Gina
Title Predictors of Responsivity to Interdisciplinary Pain Management
Journal name Pain medicine (Malden, Mass.)   Check publisher's open access policy
ISSN 1526-4637
Publication date 2017-07-25
Year available 2017
Sub-type Article (original research)
DOI 10.1093/pm/pnx169
Open Access Status Not yet assessed
Total pages 14
Place of publication Cary, NC United States
Publisher Oxford University Press
Abstract This study investigated for whom interdisciplinary pain management (IPM) is most effective. Identification of predictors of treatment responsivity would facilitate development of patient-treatment matching algorithms to optimize outcomes.

Repeated measures prospective study of consecutive admissions to a two-week IPM program.

Brisbane Pain Rehabilitation Service in Brisbane, Australia.

A total of 163 adults referred for chronic pain management.

Self-report questionnaires and measures of physical performance were obtained at program entry and completion. Group-level analyses were performed using standard parametric statistics. Individual-level change was assessed using recommended criteria. Multivariate analysis of variance and logistic regression were used to examine outcomes and predictors of response.

Significant improvements were observed across psychological, social, and physical outcome domains. Up to 50% of participants had clinically meaningful improvements, while less than 10% deteriorated. Higher baseline depression, anxiety, stress, and pain catastrophizing scores predicted better group-level outcomes ( P s < 0.05). Participants with higher baseline depression scores were most likely to show significant individual-level improvement on at least one outcome ( P s < 0.05). Participants with nociceptive pain were more than four times more likely than those with neuropathic pain to show clinically meaningful improvement on multiple outcomes, while those participants who were older were more likely to be multidomain responders.

Physical, psychological, and social outcomes all improved in a significant proportion of participants following the IPM. High baseline depression was a clinically reliable predictor of individual-level improvement. Individuals with nociceptive pain and those who were older, respectively, showed the largest response across multiple outcomes and domains.
Keyword Clinical Outcome Predictors
Interdisciplinary Pain Management
 Chronic Pain
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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Created: Wed, 15 Nov 2017, 12:14:15 EST