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How Have Chronic Pain Management Programs Progressed? A Mapping Review.
Gwyn N Lewis1, Debbie Bean2,3, Rebecca Mowat4
1Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
Multidisciplinary pain management programs (PMPs) have evolved, shifting towards cognitive behavioral methods and holistic assessments for chronic pain. While core components remain, some elements like medication withdrawal have decreased over time.
Area of Science:
- Pain Management
- Rehabilitation Medicine
- Health Services Research
Background:
- Multidisciplinary pain management programs (PMPs) are the gold standard for chronic noncancer pain.
- The specific content and structure of PMPs are not well-defined.
- Understanding PMP evolution is crucial for optimizing chronic pain care.
Purpose of the Study:
- To identify common content and structures in inpatient PMPs.
- To analyze how PMP content and structure have changed over five decades (1970s-2010s).
Main Methods:
- A mapping review of studies featuring inpatient PMPs.
- Extraction of data on program content, format, structure, clinicians, and outcomes.
- Analysis of publications across five decades.
Main Results:
- All PMPs included physical therapy and psychology; most included education.
- Physical therapy remained consistent, but psychology shifted from operant conditioning to cognitive behavioral methods.
- Involvement of nurses and occupational therapists declined, while outcome measures shifted to quality of life and general health.
Conclusions:
- PMP content and format have evolved, influenced by psychological advancements.
- Current PMPs demonstrate a more holistic approach to pain assessment and management.
- The evolution reflects a dynamic adaptation to best practices in chronic pain care.
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