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UBC Theses and Dissertations

Changes in clinical outcomes following completion of an interdisciplinary chronic pain management program and the impact of increased pain knowledge : a chart review White, Lynita Dawn


Chronic non-cancer pain is widespread and has no standard treatment. Interdisciplinary pain management has demonstrated favourable outcomes for chronic pain patients, but essential program components are not known, and the evidence is limited by lack of standardization in the literature. The purpose of this study was to evaluate the impact of the 6-week, outpatient Interdisciplinary Pain Management Program at OrionHealth Vancouver on four primary outcomes. Two other aims were to determine whether increased pain knowledge predicts clinical outcomes, and to collect participant feedback on two 90-minute pain neurophysiology education sessions in the program and to identify barriers to the uptake of information from those sessions. To accomplish this, a single group pre-test/post-test anonymous chart review was conducted and five t-tests, three hierarchical multiple regressions, and one content analysis were carried out. One hundred and thirty three clients provided data for the study, and 102 completed the program. Program completers significantly improved their scores on pain knowledge, pain interference, pain severity, depression, and opioid intake between assessment and discharge from the program, although only pain knowledge, depression, and opioid intake saw substantial increases. Pain knowledge did not significantly predict any clinical outcomes (depression, pain intensity, pain severity). The most common barriers to knowledge intake were pain intensity, pain medication, language/content of the education sessions, and the amount of information presented. The majority of participants found the information provided in the education sessions valuable, and qualitatively reported positive feedback for the education sessions. This study provides further support for interdisciplinary pain management using internationally recommended outcome measures, especially on cognitive and behavioural variables. In addition, pain knowledge was concluded not to be a candidate for predicting clinical success. However, pain neurophysiology education may be beneficial for chronic pain sufferers due to deep learning or nonspecific factors.

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