A Prospective Clinical Evaluation of Treatment Effectiveness and Patient Satisfaction Following Usual Care Intervention at a Multidisciplinary Pain Centre

Purpose of the study:  There is strong evidence obtained from controlled trials that supports the use of biopsychosocial multidisciplinary interventions for chronic pain. Yet, studies of the clinical effectiveness and routine application of these approaches in real world settings are rare. This clinical evaluation sought to prospectively track changes in physical (e.g., pain severity, pain‐related disability) and psychological (e.g., pain anxiety, pain self‐efficacy) outcomes following usual care intervention at a large pain medicine centre (PMC). The degree to which improvements in physical and psychological outcomes were related to patient satisfaction was also examined. Methods:  One hundred and nine (M age = 56.32 years, 51.4% female, pain chronicity Mdn = 5 years) of 141 invited patients who attended the PMC for the first time over a 4‐month period completed a pretreatment questionnaire comprised of standardised measures of pain, psychological function, and social background. Forty‐three and 46 patients completed the 3‐ and 6‐month follow‐up assessments respectively, which also included measures of patient satisfaction. Results:  Wiithin the initial 3 months of treatment there were no significant declines in reported pain intensity, yet patients reported significant improvements in pain relief (p < 0.05). Patients who completed the 3‐month follow‐up questionnaire reported significantly reduced levels of disability (p < 0.05), less frequent episodes of fearful appraisal and pain avoidance (p < 0.05), and a reduction in catastrophizing pain coping responses (p < 0.02). At 6 months, patients did not report any further improvements in physical and psychological function beyond what they had achieved within the first 3 months. Preliminary findings suggest that patient satisfaction with treatment is significantly related to perceived reductions in disability (p < 0.05) and improvements in self‐efficacy for coping with pain (p < 0.01), yet not significantly related to changes in pain coping style. Conclusions:  These findings highlight the importance of measuring treatment outcomes prospectively across different time points in view of the initial improvement in outcome and subsequent plateau observed here. Furthermore, these preliminary results suggest the centrality of patient beliefs pertaining to disability and confidence in their ability to cope when examining the effectiveness of pain interventions.