Predicting factors of outcome in multidisciplinary treatment of chronic neuropathic pain
Authors Shaygan M, Böger A, Kröner-Herwig B
Received 30 May 2018
Accepted for publication 7 August 2018
Published 18 October 2018 Volume 2018:11 Pages 2433—2443
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Michael A Überall
Maryam Shaygan,1 Andreas Böger,2 Birgit Kröner-Herwig3
1Department of Psychiatric Nursing, Community Based Psychiatric Care Research Centre, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran; 2Pain Management Clinic at the Red Cross Hospital, Kassel, Germany; 3Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, Georg-August-University, Göttingen, Germany
Purpose: Evidence of the effectiveness of multidisciplinary treatment with a focus on neuropathic pain is still rare. The present study investigated whether multidisciplinary treatment leads to improvement of neuropathic pain in outcome (pain intensity and disability) and psychological (depression, pain acceptance, and catastrophizing) variables at posttreatment and 3-month follow-up. We examined whether and to what extent psychological changes can predict long-term outcome at 3-month follow-up, when other variables are controlled for (baseline characteristics and changes in pain parameters).
Patients and methods: Patients suffering from a chronic neuropathic pain condition (n=141) attended an inpatient multidisciplinary program lasting about 15 continuous days with self-report data collected at pretreatment, posttreatment, and 3-month follow-up.
Results: Repeated-measures ANOVAs showed a significant improvement of pain intensity, disability, pain acceptance, catastrophizing, and depression at posttreatment. These improvements remained stable over the 3-month follow-up for all variables except for depression. The inclusion of psychological changes in multiple regression analyses greatly increased the variance in outcome, explained by baseline characteristics and changes in pain parameters.
Conclusion: The results could help clinicians to determine which variables should be emphasized during inpatient treatment and during the follow-up period, in order to maintain the gains after an inpatient multidisciplinary treatment for neuropathic pain.
Perspective: The present study demonstrates the beneficial effects of an inpatient multidisciplinary program for neuropathic pain and further question the resistant nature of neuropathic pain to treatment. The results add evidence to the relevance of cognitive-behavioral models of pain positing an important role for pain-related thoughts and emotions in long-term outcome following multidisciplinary pain treatment.
Keywords: multidisciplinary treatment, neuropathic pain, psychological variables
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