Objective: To provide outcome data measuring objective and subjective variables of an individualized, multidisciplinary, comprehensive pain management program.
Design: The study is a prospective evaluation of 50 consecutive patients who completed the pain management program. Objective measures were medication use and return to work. Subjective measures included self-reports of pain levels and completion of a Personal Concerns and Goals Assessment (PCGA) examining issues of lifestyle and emotional well-being. These measures were compared at program onset and completion by using appropriate statistical analyses.
Results: Objective measures: Medication use by the study subjects decreased overall by 72% within all drug categories. Opioid use was eliminated. Regarding return to work, the study subjects increased their work hours by twofold overall. Of patients working fewer than 30 h per week at program onset, representing 62% of the study population, a fivefold return to work was observed. Subjective measures: Overall pain levels improved by 33%, with an 18 to 47% improvement in all descriptors (average pain levels on good or bad days, average number of good or bad days). Of the PCGA factors, patients improved 24 to 46% in all categories concerning lifestyle and emotional well-being. Correlative analysis of the data produced prognostic information as well as insights into chronic pain development.
Conclusions: This study of objective and subjective outcome measures demonstrates that a comprehensive program employing specific principles and methods produces an effective approach for the management of chronic pain. Patients disabled by chronic pain regain a quality of life that allows them to resume a functioning, productive role.
Minneapolis Clinic of Neurology, and *Department of Neurology, University of Minnesota School of Medicine, Minneapolis, Minnesota
Manuscript submitted May 12, 1995; 1st revision received December 19, 1995; 2nd revision received May 10, 1996; accepted for publication September 11, 1996.
Address correspondence and reprint requests to Dr. Jack E. Hubbard, Suite 185 Ridgeview Medical Building, 305 E. Nicollet Blvd., Burnsville, MN 55337, U.S.A.