Why does the impact of multidisciplinary pain management on quality of life differ so much between chronic pain patients?

Why does the impact of multidisciplinary pain management on quality of life differ so much... Scandinavian Journal of Pain 4 (2013) 255–260Contents lists available at ScienceDirectScandinavian Journal of Painjournal homepage: www.ScandinavianJournalPain.comPoster-abstracts from SASP – the Scandinavian Association for theStudy of Pain scientific meeting, Helsinki, FI, June 13–15, 2013A1A2Why does the impact of multidisciplinary painmanagement on quality of life differ so muchbetween chronic pain patients?Health care utilization in chronic pain—Apopulation based studyThorbjörg Jonsdottir 1,2 , Helga Jonsdottir 2 ,Sigridur Gunnarsdottir 2 , Eirikur Lindal 2P. Vartiainen 1 , T. Heiskanen 1 , R.P. Roine 2 , E.Kalso 1112Pain Clinic, Department of Anaesthesiology,Intensive Care Medicine, Emergency Medicine andPain Medicine, Helsinki University Central Hospital,Helsinki, Finland2 Group Administration, Helsinki and UusimaaHospital District, Helsinki, FinlandAims: To assess the change in quality of life and factors predicting this change in 1425 chronic pain patients treated in amultidisciplinary pain clinic.Methods: This is an observational follow-up study using the 15Dgeneric health-related quality of life (HRQoL) instrument. Patientsfilled in the HRQoL questionnaire at baseline, and 6 and 12 monthsafter discharge. To assess if mental factors predicted treatment success, the changes in the overall 15D score were compared andrelated to the baseline variables of depression and distress. Thegroup of patients, who scored 4 or 5 on the 1–5 scale for thedepression and distress dimensions of the 15D instrument, wereconsidered mentally distressed (N = 199). They were comparedwith the non-distressed patients (i.e. those who scored 1; N = 401).Results: Pain was associated to depression and distress: 85.4%of mentally distressed patients scored 4 or 5 also on the discomfort and symptoms dimension, vs. 51.4% of the non-distressed(p < 0.001). The mean 15D score of the mentally distressed patientsimproved statistically significantly more (from 0.572 to 0.636,N = 141) during the first six months after treatment compared withthe 15D of those who were not mentally distressed, who improvedonly marginally (0.790–0.803, N = 294; p < 0.001).Conclusions: Patients with more severe depression or distressat baseline appear to gain more from the treatment than thosewho have less mental distress. In our ongoing study more baseline factors will be evaluated to assess their effect on the success oftreatment.http://dx.doi.org/10.1016/j.sjpain.2013.07.0031877-8860/$ – see front matterUniversity of Akureyri, Akureyri, IcelandUniversity of Iceland, Reykjavik, IcelandAims: To investigate health care utilization in relation to chronicpain.Methods: In this cross-sectional study postal questionnaires,measuring sociodemographic characteristics, pain, health relatedquality of life (HRQoL), attitudes to pain and health care utilizationpast six months, were sent to 4500 individuals aged 20–70 years,randomly drawn from the Icelandic National Registry.Results: Total response rate was 36.9% (n = 1589) and was higheramong older individuals and women. Nearly one half of respondents (47.5%, n = 754) reported chronic pain (≥3 months) withmean duration of 9.3 years (median = 6.0 years, SD = 10.0) and 57.5%of them had consulted health care service for their pain past sixmonths. Use of pain related health care was significantly relatedto attitudes towards pain and individuals with pain in chest, upperextremities, hips and lower extremities consulted health care fortheir pain significantly more often than people with other painlocations. Pain related health care utilization was not significantlyrelated to sociodemographic characteristics. There was a significant difference in both Physical (PCS) and Mental (MCS) componentHRQoL scales as well as nature of pain (severity, interference,spread and pattern), between individuals who had consulted healthcare for their pain and those who had not. However, when theserelationships were tested by using logistic regression models, onlyPCS and pain interference remained significant in this relationship.Conclusions: Chronic pain related health care utilization isrelated to several pain characteristics and its influence on daily life,where interference and physical components of HRQoL are mostimportant.http://dx.doi.org/10.1016/j.sjpain.2013.07.004 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Why does the impact of multidisciplinary pain management on quality of life differ so much between chronic pain patients?

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de Gruyter
Copyright
© 2013 Scandinavian Association for the Study of Pain
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1877-8860
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1877-8879
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10.1016/j.sjpain.2013.07.003
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Abstract

Scandinavian Journal of Pain 4 (2013) 255–260Contents lists available at ScienceDirectScandinavian Journal of Painjournal homepage: www.ScandinavianJournalPain.comPoster-abstracts from SASP – the Scandinavian Association for theStudy of Pain scientific meeting, Helsinki, FI, June 13–15, 2013A1A2Why does the impact of multidisciplinary painmanagement on quality of life differ so muchbetween chronic pain patients?Health care utilization in chronic pain—Apopulation based studyThorbjörg Jonsdottir 1,2 , Helga Jonsdottir 2 ,Sigridur Gunnarsdottir 2 , Eirikur Lindal 2P. Vartiainen 1 , T. Heiskanen 1 , R.P. Roine 2 , E.Kalso 1112Pain Clinic, Department of Anaesthesiology,Intensive Care Medicine, Emergency Medicine andPain Medicine, Helsinki University Central Hospital,Helsinki, Finland2 Group Administration, Helsinki and UusimaaHospital District, Helsinki, FinlandAims: To assess the change in quality of life and factors predicting this change in 1425 chronic pain patients treated in amultidisciplinary pain clinic.Methods: This is an observational follow-up study using the 15Dgeneric health-related quality of life (HRQoL) instrument. Patientsfilled in the HRQoL questionnaire at baseline, and 6 and 12 monthsafter discharge. To assess if mental factors predicted treatment success, the changes in the overall 15D score were compared andrelated to the baseline variables of depression and distress. Thegroup of patients, who scored 4 or 5 on the 1–5 scale for thedepression and distress dimensions of the 15D instrument, wereconsidered mentally distressed (N = 199). They were comparedwith the non-distressed patients (i.e. those who scored 1; N = 401).Results: Pain was associated to depression and distress: 85.4%of mentally distressed patients scored 4 or 5 also on the discomfort and symptoms dimension, vs. 51.4% of the non-distressed(p < 0.001). The mean 15D score of the mentally distressed patientsimproved statistically significantly more (from 0.572 to 0.636,N = 141) during the first six months after treatment compared withthe 15D of those who were not mentally distressed, who improvedonly marginally (0.790–0.803, N = 294; p < 0.001).Conclusions: Patients with more severe depression or distressat baseline appear to gain more from the treatment than thosewho have less mental distress. In our ongoing study more baseline factors will be evaluated to assess their effect on the success oftreatment.http://dx.doi.org/10.1016/j.sjpain.2013.07.0031877-8860/$ – see front matterUniversity of Akureyri, Akureyri, IcelandUniversity of Iceland, Reykjavik, IcelandAims: To investigate health care utilization in relation to chronicpain.Methods: In this cross-sectional study postal questionnaires,measuring sociodemographic characteristics, pain, health relatedquality of life (HRQoL), attitudes to pain and health care utilizationpast six months, were sent to 4500 individuals aged 20–70 years,randomly drawn from the Icelandic National Registry.Results: Total response rate was 36.9% (n = 1589) and was higheramong older individuals and women. Nearly one half of respondents (47.5%, n = 754) reported chronic pain (≥3 months) withmean duration of 9.3 years (median = 6.0 years, SD = 10.0) and 57.5%of them had consulted health care service for their pain past sixmonths. Use of pain related health care was significantly relatedto attitudes towards pain and individuals with pain in chest, upperextremities, hips and lower extremities consulted health care fortheir pain significantly more often than people with other painlocations. Pain related health care utilization was not significantlyrelated to sociodemographic characteristics. There was a significant difference in both Physical (PCS) and Mental (MCS) componentHRQoL scales as well as nature of pain (severity, interference,spread and pattern), between individuals who had consulted healthcare for their pain and those who had not. However, when theserelationships were tested by using logistic regression models, onlyPCS and pain interference remained significant in this relationship.Conclusions: Chronic pain related health care utilization isrelated to several pain characteristics and its influence on daily life,where interference and physical components of HRQoL are mostimportant.http://dx.doi.org/10.1016/j.sjpain.2013.07.004

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Scandinavian Journal of Painde Gruyter

Published: Oct 1, 2013

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