Assessing clinically meaningful change following a programme for managing chronic pain
1Wolfson Neurorehabilitation Centre, London, UK. Keren.Fisher@rnoh.nhs.uk
Clinical Rehabilitation
|February 21, 2008
Summary
Goal Attainment Scaling identified clinically meaningful pain improvements. Patients in a pain management program showed significantly greater improvements than those on a waiting list, demonstrating program effectiveness.
Area of Science:
- Rehabilitation Medicine
- Clinical Psychology
- Pain Management
Background:
- Chronic musculoskeletal pain affects millions, necessitating effective management strategies.
- Assessing the true impact of pain management programs requires defining clinically meaningful improvements.
- Goal Attainment Scaling (GAS) offers a patient-centered approach to evaluating treatment success.
Purpose of the Study:
- To establish criteria for clinically meaningful change scores using GAS.
- To compare the achievement of these meaningful changes in a pain management program versus a waiting list control group.
Main Methods:
- Seventy-three chronic pain patients were assessed using multiple measures, including GAS.
- A 3-week cognitive behavioral pain management program was implemented.
- ANOVA was used to analyze mean score differences across GAS achievement groups.
Main Results:
- Clinically meaningful changes were defined for the Numerical Rating Scale (NRS; -3), Oswestry Disability Questionnaire (ODQ; -12), and functional tests (walk +87, stairs +14).
- Participants in the pain management program achieved these meaningful changes significantly more often than the waiting list group.
Conclusions:
- GAS effectively identified clinically meaningful improvements in pain and disability.
- The pain management program demonstrated superior patient outcomes compared to a waiting list condition.
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