Research report: PDF OnlyNon-institutional treatment of chronic pain by field management: an outcome study with comparison groupCott, Arthur∗; Anchel, Harvey; Goldberg, William M.; Fabich, Marion; Parkinson, WilliamAuthor Information Behavioural Medicine Unit, Department of Medicine, St. Joseph's Hospital/McMaster University, Hamilton, Ont.Canada ∗Correspondence to: Dr. Arthur Cott, Behavioural Medicine Unit, St. Joseph's Hospital, Fontbonne Hall, 301 James St. S., Hamilton, Ont. L8N 4A6, Canada. Submitted April 6, 1989; revised August 23, 1989; accepted August 25, 1989. Pain: February 1990 - Volume 40 - Issue 2 - p 183-194 doi: 10.1016/0304-3959(90)90069-P Buy Metrics Abstract Field management, through the use of specially trained field consultants, is a mechanism by which interdisciplinary interventions can be implemented in non-institutional settings. Management of the real environmental determinants (home, work, social) of pain and disability should improve the effectiveness of behaviorally based interventions and make these treatments more accessible. Over a 6 year period, 261 patients having various chronic somatic complaints (e.g., pain, fatigue, gastrointestinal complaints) underwent interdisciplinary outpatient treatment based on medical and behavioral sciences. Comparison of patients having field management with patients receiving office-based treatment found a significantly greater reduction in disability with field management. 84% of field managed patients had a successful outcome as defined by: (a) return to regular work, or (b) reduced limitations on work, exercise, and daily living activities, depending on functional status at assessment. Only 61% of patients with office-based treatment were successful. Compliance, defined as the frequency with which treatment was mutually terminated, was significantly higher with field management. The availability of long-term disability benefits was highly predictive of a poorer outcome. However, field management remained effective for improving functional status regardless of the availability of benefits. Finally, determination of the cost of non-institutional treatment indicated that field management is a cost-effective modality. Implications of these findings for the treatment of disability in chronic pain and other chronic illness syndromes are discussed. © Lippincott-Raven Publishers.