Predicting treatment compliance following facial pain evaluation

The purpose of this study was to document compliance to treatment follow-up for facial pain patients referred for outside services. In addition, we generated a multidimensional model of the psychosocial constructs associated with chronic pain to determine whether these factors were predictive of compliance across recommended therapy modalities or with an overall measure of compliance. These constructs included pain report, depressive symptoms, anxiety, cognitive coping strategies, and physical activity reduction. The sample consisted of 80 facial pain patients evaluated at a tertiary care, facial pain clinic at a large university medical center. Compliance ratings ranged from 93% to 50% and are consistent with the literature that indicates that compliance differs across treatment modality. Furthermore, compliance rates were lower for the more nontraditional facial pain treatments performed by physical therapists or psychologists. Depression was negatively associated with compliance to medication changes, therapeutic injections, and splint therapy, but not psychological counseling or physical therapy. Increased pain was only associated with physical therapy. Measures of psychological distress (depression and anxiety) and pain were predictive of the overall measure of compliance. These results suggest that psychological distress can be a barrier for positive patient outcomes through reduced treatment compliance.