Recognizing desired treatment outcomes in complex chronic pain cases may be beneficial for identifying the best pain management plan, since desired outcomes may be less likely to occur, according to study results published in Pain Practice.
Researchers used data from the large prospective registry cohort, called DATAPAIN, which included patient-reported outcome measures (PROMs), sociodemographic factors, and chronic pain-related data to determine whether complex chronic pain cases were less likely to achieve treatment success when compared with noncomplex chronic pain cases. Data collected between March 2016 and June 2020 were used in the longitudinal analysis of the study. A total of 1637 patients aged 18 years and older with baseline pain for more than 3 months were included in the study.
Of the patients included in the study, 21.08% were complex chronic pain cases (mean [SD] age, 60.88[14.32] years; men, 50.14%) and 78.92% were noncomplex chronic pain cases (mean age, 60.24[13.22] years; women, 58.75%). Among the primary outcomes, pain relief on the Numeric Rating Scale (NRS) showed similar changes at follow-up between the 2 groups (-1.3 for noncomplex cases vs -1.32 for complex cases). Treatment success rates on the Patient Global Impression of Change (PGIC) at follow-up were lower for the complex chronic pain cases.
Among the secondary outcomes, general health on the General Perceived Health (GPH) was lower for the complex chronic pain cases. Additionally, pain interference in daily life on the Brief Pain Inventory (BPI) showed a high pain interference on psychical and emotional activities of daily life in the complex chronic pain cases.
Study limitations include not routinely collecting other important data due to using a registry cohort.
Researchers concluded, “When treating complex patients, the desired treatment outcome(s) should be recognized by the specialist and patient before initiating treatment, as these may be less likely to occur depending on the outcome and may improve the quality of pain management, such as in monitoring pain processes and reassessing pain management plans to the needs of the patients.”
Waardenburg S, de Meij N, van Kuijk SMJ, Van Zundert J, Brouwer BA. Expectations of treatment outcome in complex cases of patients with chronic pain: A study on the DATAPAIN cohort. Pain Pract. Published online July 21, 2023. doi:10.1111/papr.13274