Chronic pain patients managed in a multidisciplinary pain centre compared to general practice

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Pain. 2000 Feb;84(2-3):203-11.

Treatment outcome of chronic non-malignant pain patients managed in a

danish multidisciplinary pain centre compared to general practice: a

randomised controlled trial.

Becker N, Sjogren P, Bech P, Olsen AK, sen J.

H:S Multidisciplinary Pain Centre, Danish National Hospital, Copenhagen

University Hospital, Tagensvej 18B, 7122, DK-2200, Copenhagen, Denmark.

nielsbecker@...

This randomised controlled study investigated the effect of outpatient

multidisciplinary pain centre treatment (MPT) compared with treatment by

a general practitioner after initial supervision by a pain specialist

(GP-group) and with a group of patients waiting for 6 months before

treatment was initiated (WL-group). One-hundred-and-eighty-nine chronic

non-malignant pain patients were studied. At referral, and after 3 and 6

months patients filled in questionnaires evaluating pain intensity,

health related quality of life (HRQL) and use of analgesics. HRQL was

evaluated using the Medical Outcome Study-Short Form (SF-36), the

Hospital Anxiety and Depression scale (HAD) and the Psychological

General Well-being Scale (PGWB). After 6 months patients allocated to

MPT (n=63) reported statistically significant reduction in pain

intensity (VAS-score, P<0.001), improvement in psychological well-being

(PGWB, P<0.001), quality of sleep (P<0.05) and physical functioning

(SF-36-Phycical Functioning, P<0.05). No improvements were seen in the

GP-group (n=63). In the WL-group (n=63) a statistically significant

deterioration was observed in PGWB-scores, HAD-scores and in 6 of 8

SF-36-subscores (P </= 0.05). A reduction in use of opioids administered

on demand was obtained in the group receiving MPT (P<0.001). In the MPT-

and GP-groups a decrease in the use of short acting opioids was observed

(P<0.01). No change in use of analgesics was seen in the WL-group. The

study showed that (i) in the MPT-group there was a significant reduction

in pain intensity and improvement of HRQL compared to the WL-group, and

(ii) the mere establishment of a pain diagnosis and a pain management

plan by a pain specialist was not sufficient to enable the referring GP

to manage severely chronic pain patients.

Publication Types:

a.. Clinical Trial

b.. Randomized Controlled Trial

PMID: 10666525

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