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Efficacy and cost‐effectiveness: A study of different treatment approaches in a tertiary pain centre
Author(s) -
Vanhaudenhuyse A.,
Gillet A.,
Malaise N.,
Salamun I.,
Barsics C.,
Grosdent S.,
Maquet D.,
Nyssen AS.,
Faymonville ME.
Publication year - 2015
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.674
Subject(s) - biopsychosocial model , hypnosis , physical therapy , anxiety , psychosocial , medicine , chronic pain , quality of life (healthcare) , psychological intervention , pain catastrophizing , depression (economics) , alternative medicine , psychiatry , nursing , pathology , economics , macroeconomics
Background Chronic pain is considered to be a complex phenomenon, involving an interrelation of biological, psychosocial and sociocultural factors. Currently, no single treatment or therapy can address all aspects of this pathology. In our expert tertiary pain centre, we decide to assess the effectiveness of four treatments for chronic pain classically proposed in our daily clinical work: physiotherapy; psycho‐education; physiotherapy combined with psycho‐education; and self‐hypnosis/self‐care learning. Methods This study included 527 chronic pain patients, with a mean duration of pain of 10 years. Patients were allocated either to one of the four pre‐cited treatment groups or to the control group. Pain intensity, quality of life, pain interference, anxiety and depression were assessed before and after treatment. Results This study revealed a significant positive effect on pain interference and anxiety in patients included in the physiotherapy combined with psycho‐education group, after 20 sessions spread over 9 months of treatment. The most prominent results were obtained for patients allocated to the self‐hypnosis/self‐care group, although they received only six sessions over a 9‐month period. These patients showed significant benefits in the areas of pain intensity, pain interference, anxiety, depression and quality of life. Conclusions This clinical report demonstrates the relevance of biopsychosocial approaches in the improvement of pain and psychological factors in chronic pain patients. The study further reveals the larger impact of self‐hypnosis/self‐care learning treatment, in addition to a cost‐effectiveness benefit of this treatment comparative to other interventions.