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Pain management programme for Chinese patients: a 10-year outcome review
M C Chu1, Rainbow K Y Law2, Leo C T Cheung3
1Department of Anaesthesia, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Objectives:
To review the clinical and social benefits of a pain management programme in Hong Kong.
Design:
Prospective cohort study.
Setting:
Tertiary out-patient clinic, Hong Kong.
Participants:
Patients with chronic non-cancer pain and prolonged (mean, 46 months) psychosocial disability who joined the Comprehensive Outpatient Pain Engagement programme between 2002 and 2012.
Intervention:
A structured 6-week out-patient pain rehabilitation course designed to improve function and reduce disability, regardless of the cause or severity of pain.
Main Outcome Measures:
Social outcomes included return-to-work rate, hospital admissions, and out-patient visits. Physical outcomes included tolerance to sitting and standing. Psychological constructs such as mood, catastrophisation, self-efficacy, quality of life, and perceived performances were used. Each measure was taken before and 1 year after the programme.
Results:
There was significant increase in return-to-work rate 1 year after commencement of the programme (35% after vs 17% before the programme; odds ratio=3.01), reduction in medical utilisation, and improvement in all physical and psychological measures. Pain intensity, psychological distress, and history of work-related injuries were not related to the likelihood of return to work. Shorter duration of pain and higher physical functioning score in 36-Item Short-Form Health Survey were prognostic indicators.
Conclusions:
Patients with chronic pain who joined the Comprehensive Outpatient Pain Engagement programme showed significant functional improvement despite the long history of pain.
