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The dissatisfied patient with chronic pain.
David W Swanson1, Wendell M Swenson, Toshihiko Maruta
1Mayo Clinic and Mayo Foundation, Rochester, Minn. 55901 U.S.A.
Pain
|April 1, 1978
Summary
Patients with chronic pain can become dissatisfied with treatment. This study highlights challenges in managing highly chronic and treatment-refractory pain patients, emphasizing the need for psychiatric screening.
Area of Science:
- Pain Management
- Psychiatry
- Clinical Psychology
Background:
- Chronic pain patients often experience dissatisfaction due to lack of improvement.
- Pain management programs aim to address complex patient needs.
- Treatment-refractory cases present unique clinical challenges.
Observation:
- Thirteen patients with chronic pain formally complained of dissatisfaction within a pain management program.
- These patients exhibited extreme chronicity, treatment resistance, medication dependency, and accident proneness.
- They opposed psychological interventions and demonstrated medication dependency, with some exhibiting delusions.
Findings:
- Applying standard pain management protocols was difficult for this patient cohort.
- Patients resisted treatment recommendations and even discharge, indicating complex psychosocial issues.
- The study identified significant challenges in integrating these patients into conventional pain management.
Implications:
- Further psychiatric screening is crucial for identifying and managing patients with complex chronic pain.
- This can help prevent complications and improve treatment outcomes for difficult-to-treat populations.
- Understanding these patient profiles can refine pain management program strategies.