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Does smoking status affect multidisciplinary pain facility treatment outcome?
David A Fishbain1, John E Lewis, Robert Cutler
1Department of Psychiatry, Miller School of Medicine at University of Miami, Florida 33136, USA. d.fishbain@miami.edu
Pain Medicine (Malden, Mass.)
|December 11, 2008
Summary
Current smokers with chronic low back pain (LBP) had poorer treatment outcomes and were less likely to be employed post-treatment. Pain and worker compensation status predicted return to work for smokers.
Area of Science:
- Pain Medicine
- Rehabilitation Medicine
- Public Health
Background:
- Smoking is prevalent among patients with chronic low back pain (LBP).
- The impact of smoking status on treatment outcomes in LBP patients is not fully understood.
- Multidisciplinary pain facilities aim to improve functional outcomes for LBP patients.
Purpose of the Study:
- To investigate the association between smoking status and treatment outcomes in chronic LBP patients.
- To identify factors predicting employment status among smokers undergoing multidisciplinary pain treatment.
Main Methods:
- A cohort of chronic LBP patients (smokers N=81, nonsmokers N=140) were assessed.
- Employment status was compared at 1, 6, 12, and 24 months post-treatment.
- Logistic regression identified predictors of non-employment in smokers.
Main Results:
- Current smokers were significantly less likely to be employed at all follow-up points.
- Higher pain levels predicted employment status for smokers at 1, 12, and 24 months.
- Worker compensation status predicted employment status at 6 months for smokers.
Conclusions:
- Smoking is linked to worse treatment outcomes and lower employment rates in chronic LBP patients.
- Pain intensity and worker compensation claims are key predictors of return to work for smokers.
- Targeted monitoring and interventions for smokers with high perceived pain are recommended to improve outcomes.
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