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Predictors of Responsivity to Interdisciplinary Pain Management
Abstract Objective This study investigated for whom interdisciplinary pain management (IPM) is most effective. Identification of predictors of treatment responsivity would facilitate development of patient-treatment matching algorithms to optimize outcomes. Design Repeated measures prospective study...
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| Published in: | Pain medicine (Malden, Mass.) Mass.), 2018-09, Vol.19 (9), p.1848-1861 |
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| Main Authors: | , , , , , , |
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| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c470t-a3b2c370f030678b58cffd5a8563d07962c335d6e005e39b9fa05dc3257ebfef3 |
| container_end_page | 1861 |
| container_issue | 9 |
| container_start_page | 1848 |
| container_title | Pain medicine (Malden, Mass.) |
| container_volume | 19 |
| creator | Day, Melissa A Brinums, Melissa Craig, Nathan Geffen, Laurence Geffen, Saul Lovai, Miriam Geffen, Gina |
| description | Abstract
Objective
This study investigated for whom interdisciplinary pain management (IPM) is most effective. Identification of predictors of treatment responsivity would facilitate development of patient-treatment matching algorithms to optimize outcomes.
Design
Repeated measures prospective study of consecutive admissions to a two-week IPM program.
Setting
Brisbane Pain Rehabilitation Service in Brisbane, Australia.
Subjects
A total of 163 adults referred for chronic pain management.
Methods
Self-report questionnaires and measures of physical performance were obtained at program entry and completion. Group-level analyses were performed using standard parametric statistics. Individual-level change was assessed using recommended criteria. Multivariate analysis of variance and logistic regression were used to examine outcomes and predictors of response.
Results
Significant improvements were observed across psychological, social, and physical outcome domains. Up to 50% of participants had clinically meaningful improvements, while less than 10% deteriorated. Higher baseline depression, anxiety, stress, and pain catastrophizing scores predicted better group-level outcomes (Ps |
| doi_str_mv | 10.1093/pm/pnx169 |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1988265744</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A588341860</galeid><oup_id>10.1093/pm/pnx169</oup_id><sourcerecordid>A588341860</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-a3b2c370f030678b58cffd5a8563d07962c335d6e005e39b9fa05dc3257ebfef3</originalsourceid><addsrcrecordid>eNp9kVtLHTEUhUOx1Et96B8oA_ZBH84xl8llnkTEGyhKaZ9DJrMjkZlkTGak_ntzOKeVFil5SNj51mKxF0JfCF4S3LDjcTgewy8img9oh3AqFrVgcmvzpkzybbSb8yPGRNSKfULbtMGUEyZ20Ml9gs7bKaZcRVd9hzzGkP2zn16qKVbXYYLU-Wz92Ptg0kt1b3yobk0wDzBAmD6jj870GfY39x76eXH-4-xqcXN3eX12erOwtcTTwrCWWiaxwwwLqVqurHMdN4oL1mHZiPLLeCcAYw6saRtnMO8so1xC68CxPXS49h1TfJohT3ooqaDvTYA4Z00apajgsq4LevAP-hjnFEo6TRlmkgqh-Bv1YHrQPrg4JWNXpvqUK8VqogQu1PIdqpwOBm9jAOfL_C_B0VpgU8w5gdNj8kNZnCZYr8rS46DXZRX26ybo3A7Q_SF_t1OAb2sgzuN_fF4B0KOaMQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2303726685</pqid></control><display><type>article</type><title>Predictors of Responsivity to Interdisciplinary Pain Management</title><source>Oxford Journals Online</source><creator>Day, Melissa A ; Brinums, Melissa ; Craig, Nathan ; Geffen, Laurence ; Geffen, Saul ; Lovai, Miriam ; Geffen, Gina</creator><creatorcontrib>Day, Melissa A ; Brinums, Melissa ; Craig, Nathan ; Geffen, Laurence ; Geffen, Saul ; Lovai, Miriam ; Geffen, Gina</creatorcontrib><description>Abstract
Objective
This study investigated for whom interdisciplinary pain management (IPM) is most effective. Identification of predictors of treatment responsivity would facilitate development of patient-treatment matching algorithms to optimize outcomes.
Design
Repeated measures prospective study of consecutive admissions to a two-week IPM program.
Setting
Brisbane Pain Rehabilitation Service in Brisbane, Australia.
Subjects
A total of 163 adults referred for chronic pain management.
Methods
Self-report questionnaires and measures of physical performance were obtained at program entry and completion. Group-level analyses were performed using standard parametric statistics. Individual-level change was assessed using recommended criteria. Multivariate analysis of variance and logistic regression were used to examine outcomes and predictors of response.
Results
Significant improvements were observed across psychological, social, and physical outcome domains. Up to 50% of participants had clinically meaningful improvements, while less than 10% deteriorated. Higher baseline depression, anxiety, stress, and pain catastrophizing scores predicted better group-level outcomes (Ps < 0.05). Participants with higher baseline depression scores were most likely to show significant individual-level improvement on at least one outcome (Ps < 0.05). Participants with nociceptive pain were more than four times more likely than those with neuropathic pain to show clinically meaningful improvement on multiple outcomes, while those participants who were older were more likely to be multidomain responders.
Conclusions
Physical, psychological, and social outcomes all improved in a significant proportion of participants following the IPM. High baseline depression was a clinically reliable predictor of individual-level improvement. Individuals with nociceptive pain and those who were older, respectively, showed the largest response across multiple outcomes and domains.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnx169</identifier><identifier>PMID: 29025136</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Algorithms ; Analysis ; Anxiety ; Care and treatment ; Chronic pain ; Chronic Pain - therapy ; Female ; Humans ; Interdisciplinary aspects ; Male ; Mental depression ; Middle Aged ; Multivariate analysis ; Neuralgia ; Pain management ; Pain Management - methods ; Pain perception ; Prospective Studies ; Rehabilitation ; Statistical analysis ; Stress (Psychology) ; Treatment Outcome ; Young Adult</subject><ispartof>Pain medicine (Malden, Mass.), 2018-09, Vol.19 (9), p.1848-1861</ispartof><rights>2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2017</rights><rights>COPYRIGHT 2018 Oxford University Press</rights><rights>2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-a3b2c370f030678b58cffd5a8563d07962c335d6e005e39b9fa05dc3257ebfef3</citedby><cites>FETCH-LOGICAL-c470t-a3b2c370f030678b58cffd5a8563d07962c335d6e005e39b9fa05dc3257ebfef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29025136$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Day, Melissa A</creatorcontrib><creatorcontrib>Brinums, Melissa</creatorcontrib><creatorcontrib>Craig, Nathan</creatorcontrib><creatorcontrib>Geffen, Laurence</creatorcontrib><creatorcontrib>Geffen, Saul</creatorcontrib><creatorcontrib>Lovai, Miriam</creatorcontrib><creatorcontrib>Geffen, Gina</creatorcontrib><title>Predictors of Responsivity to Interdisciplinary Pain Management</title><title>Pain medicine (Malden, Mass.)</title><addtitle>Pain Med</addtitle><description>Abstract
Objective
This study investigated for whom interdisciplinary pain management (IPM) is most effective. Identification of predictors of treatment responsivity would facilitate development of patient-treatment matching algorithms to optimize outcomes.
Design
Repeated measures prospective study of consecutive admissions to a two-week IPM program.
Setting
Brisbane Pain Rehabilitation Service in Brisbane, Australia.
Subjects
A total of 163 adults referred for chronic pain management.
Methods
Self-report questionnaires and measures of physical performance were obtained at program entry and completion. Group-level analyses were performed using standard parametric statistics. Individual-level change was assessed using recommended criteria. Multivariate analysis of variance and logistic regression were used to examine outcomes and predictors of response.
Results
Significant improvements were observed across psychological, social, and physical outcome domains. Up to 50% of participants had clinically meaningful improvements, while less than 10% deteriorated. Higher baseline depression, anxiety, stress, and pain catastrophizing scores predicted better group-level outcomes (Ps < 0.05). Participants with higher baseline depression scores were most likely to show significant individual-level improvement on at least one outcome (Ps < 0.05). Participants with nociceptive pain were more than four times more likely than those with neuropathic pain to show clinically meaningful improvement on multiple outcomes, while those participants who were older were more likely to be multidomain responders.
Conclusions
Physical, psychological, and social outcomes all improved in a significant proportion of participants following the IPM. High baseline depression was a clinically reliable predictor of individual-level improvement. Individuals with nociceptive pain and those who were older, respectively, showed the largest response across multiple outcomes and domains.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Algorithms</subject><subject>Analysis</subject><subject>Anxiety</subject><subject>Care and treatment</subject><subject>Chronic pain</subject><subject>Chronic Pain - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Interdisciplinary aspects</subject><subject>Male</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neuralgia</subject><subject>Pain management</subject><subject>Pain Management - methods</subject><subject>Pain perception</subject><subject>Prospective Studies</subject><subject>Rehabilitation</subject><subject>Statistical analysis</subject><subject>Stress (Psychology)</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kVtLHTEUhUOx1Et96B8oA_ZBH84xl8llnkTEGyhKaZ9DJrMjkZlkTGak_ntzOKeVFil5SNj51mKxF0JfCF4S3LDjcTgewy8img9oh3AqFrVgcmvzpkzybbSb8yPGRNSKfULbtMGUEyZ20Ml9gs7bKaZcRVd9hzzGkP2zn16qKVbXYYLU-Wz92Ptg0kt1b3yobk0wDzBAmD6jj870GfY39x76eXH-4-xqcXN3eX12erOwtcTTwrCWWiaxwwwLqVqurHMdN4oL1mHZiPLLeCcAYw6saRtnMO8so1xC68CxPXS49h1TfJohT3ooqaDvTYA4Z00apajgsq4LevAP-hjnFEo6TRlmkgqh-Bv1YHrQPrg4JWNXpvqUK8VqogQu1PIdqpwOBm9jAOfL_C_B0VpgU8w5gdNj8kNZnCZYr8rS46DXZRX26ybo3A7Q_SF_t1OAb2sgzuN_fF4B0KOaMQ</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Day, Melissa A</creator><creator>Brinums, Melissa</creator><creator>Craig, Nathan</creator><creator>Geffen, Laurence</creator><creator>Geffen, Saul</creator><creator>Lovai, Miriam</creator><creator>Geffen, Gina</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20180901</creationdate><title>Predictors of Responsivity to Interdisciplinary Pain Management</title><author>Day, Melissa A ; Brinums, Melissa ; Craig, Nathan ; Geffen, Laurence ; Geffen, Saul ; Lovai, Miriam ; Geffen, Gina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-a3b2c370f030678b58cffd5a8563d07962c335d6e005e39b9fa05dc3257ebfef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Algorithms</topic><topic>Analysis</topic><topic>Anxiety</topic><topic>Care and treatment</topic><topic>Chronic pain</topic><topic>Chronic Pain - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Interdisciplinary aspects</topic><topic>Male</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neuralgia</topic><topic>Pain management</topic><topic>Pain Management - methods</topic><topic>Pain perception</topic><topic>Prospective Studies</topic><topic>Rehabilitation</topic><topic>Statistical analysis</topic><topic>Stress (Psychology)</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Day, Melissa A</creatorcontrib><creatorcontrib>Brinums, Melissa</creatorcontrib><creatorcontrib>Craig, Nathan</creatorcontrib><creatorcontrib>Geffen, Laurence</creatorcontrib><creatorcontrib>Geffen, Saul</creatorcontrib><creatorcontrib>Lovai, Miriam</creatorcontrib><creatorcontrib>Geffen, Gina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database (ProQuest)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Day, Melissa A</au><au>Brinums, Melissa</au><au>Craig, Nathan</au><au>Geffen, Laurence</au><au>Geffen, Saul</au><au>Lovai, Miriam</au><au>Geffen, Gina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Responsivity to Interdisciplinary Pain Management</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><addtitle>Pain Med</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>19</volume><issue>9</issue><spage>1848</spage><epage>1861</epage><pages>1848-1861</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><abstract>Abstract
Objective
This study investigated for whom interdisciplinary pain management (IPM) is most effective. Identification of predictors of treatment responsivity would facilitate development of patient-treatment matching algorithms to optimize outcomes.
Design
Repeated measures prospective study of consecutive admissions to a two-week IPM program.
Setting
Brisbane Pain Rehabilitation Service in Brisbane, Australia.
Subjects
A total of 163 adults referred for chronic pain management.
Methods
Self-report questionnaires and measures of physical performance were obtained at program entry and completion. Group-level analyses were performed using standard parametric statistics. Individual-level change was assessed using recommended criteria. Multivariate analysis of variance and logistic regression were used to examine outcomes and predictors of response.
Results
Significant improvements were observed across psychological, social, and physical outcome domains. Up to 50% of participants had clinically meaningful improvements, while less than 10% deteriorated. Higher baseline depression, anxiety, stress, and pain catastrophizing scores predicted better group-level outcomes (Ps < 0.05). Participants with higher baseline depression scores were most likely to show significant individual-level improvement on at least one outcome (Ps < 0.05). Participants with nociceptive pain were more than four times more likely than those with neuropathic pain to show clinically meaningful improvement on multiple outcomes, while those participants who were older were more likely to be multidomain responders.
Conclusions
Physical, psychological, and social outcomes all improved in a significant proportion of participants following the IPM. High baseline depression was a clinically reliable predictor of individual-level improvement. Individuals with nociceptive pain and those who were older, respectively, showed the largest response across multiple outcomes and domains.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29025136</pmid><doi>10.1093/pm/pnx169</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1526-2375 |
| ispartof | Pain medicine (Malden, Mass.), 2018-09, Vol.19 (9), p.1848-1861 |
| issn | 1526-2375 1526-4637 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1988265744 |
| source | Oxford Journals Online |
| subjects | Adolescent Adult Aged Aged, 80 and over Algorithms Analysis Anxiety Care and treatment Chronic pain Chronic Pain - therapy Female Humans Interdisciplinary aspects Male Mental depression Middle Aged Multivariate analysis Neuralgia Pain management Pain Management - methods Pain perception Prospective Studies Rehabilitation Statistical analysis Stress (Psychology) Treatment Outcome Young Adult |
| title | Predictors of Responsivity to Interdisciplinary Pain Management |
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