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Prognostic factors for pain relief and functional improvement in chronic pain after inpatient rehabilitation


Fuss, Isabelle; Angst, Felix; Lehmann, Susanne; Michel, Beat A; Aeschlimann, André (2014). Prognostic factors for pain relief and functional improvement in chronic pain after inpatient rehabilitation. The Clinical Journal of Pain, 30(4):279-285.

Abstract

OBJECTIVE:: To determine the factors associated with pain relief and improved physical functioning in chronic pain patients during outpatient management in the first 5 months immediately after a standardized inpatient pain management program. METHODS:: Prospective cohort study using standardized questionnaires on sociodemographic data, disease outcome, psychosocial factors, change in behavior, and outpatient therapies on discharge from inpatient rehabilitation and during the 5-month follow-up at home (observation period). Stepwise forward multivariate linear regression analysis examined the correlation of these factors with change in pain severity and change in physical functioning. RESULTS:: The study included 80.1% female patients, 90.0% had at least 1 comorbidity and 62.9% had chronic pain for≥5 years. On average, pain intensity and depression worsened slightly during the observation period, but the other outcomes remained almost stable. Relief from anxiety (20.7% explained variance) and low baseline depression (5.5%) were the most important predictors for pain relief. Relief from anxiety (13.3%) and low baseline depression (7.1%) were most strongly associated with functional improvement. CONCLUSIONS:: This study found a strong association of change in pain severity and physical functioning with change in baseline level of affective health and coping during the first outpatient management period after inpatient rehabilitation. As a consequence, it may be possible to improve the treatment of chronic pain by therapy of mood and coping.

Abstract

OBJECTIVE:: To determine the factors associated with pain relief and improved physical functioning in chronic pain patients during outpatient management in the first 5 months immediately after a standardized inpatient pain management program. METHODS:: Prospective cohort study using standardized questionnaires on sociodemographic data, disease outcome, psychosocial factors, change in behavior, and outpatient therapies on discharge from inpatient rehabilitation and during the 5-month follow-up at home (observation period). Stepwise forward multivariate linear regression analysis examined the correlation of these factors with change in pain severity and change in physical functioning. RESULTS:: The study included 80.1% female patients, 90.0% had at least 1 comorbidity and 62.9% had chronic pain for≥5 years. On average, pain intensity and depression worsened slightly during the observation period, but the other outcomes remained almost stable. Relief from anxiety (20.7% explained variance) and low baseline depression (5.5%) were the most important predictors for pain relief. Relief from anxiety (13.3%) and low baseline depression (7.1%) were most strongly associated with functional improvement. CONCLUSIONS:: This study found a strong association of change in pain severity and physical functioning with change in baseline level of affective health and coping during the first outpatient management period after inpatient rehabilitation. As a consequence, it may be possible to improve the treatment of chronic pain by therapy of mood and coping.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Rheumatology Clinic and Institute of Physical Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2014
Deposited On:06 Jan 2014 10:23
Last Modified:05 Apr 2016 17:19
Publisher:Lippincott, Williams & Wilkins
ISSN:0749-8047
Publisher DOI:https://doi.org/10.1097/AJP.0b013e31829a4d11
PubMed ID:23792343

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