Use the Back button in your browser to see the other results of your search or to select another record.
Treatment outcome of chronic non-malignant pain patients managed in a Danish multidisciplinary pain centre compared to general practice: a randomised controlled trial |
Becker N, Sjogren P, Bech P, Olsen AK, Eriksen J |
Pain 2000 Feb;84(2-3):203-211 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
This randomised controlled study investigated the effect of outpatient multidisciplinary pain centre treatment (MPT) compared with treatment by a general practitioner after initial supervision by a pain specialist (GP-group) and with a group of patients waiting for 6 months before treatment was initiated (WL-group). One-hundred-and-eighty-nine chronic non-malignant pain patients were studied. At referral, and after 3 and 6 months patients filled in questionnaires evaluating pain intensity, health related quality of life (HRQL) and use of analgesics. HRQL was evaluated using the Medical Outcome Study-Short Form (SF-36), the Hospital Anxiety and Depression scale (HAD) and the Psychological General Well-being Scale (PGWB). After 6 months patients allocated, to MPT (n = 63) reported statistically significant reduction in pain intensity (VAS-score, p < 0.001), improvement in psychological well-being (PGWB, p < 0.001), quality of sleep (p < 0.05) and physical functioning (SF-36-Phycical Functioning, p < 0.05). No improvements were seen in the GP-group (n = 63). In the WL-group (n = 63) a statistically significant deterioration was observed in PGWB-scores, HAD-scores and in 6 of 8 SF-36-subscores (p <= 0.05). A reduction in use of opioids administered on demand was obtained in the-group receiving MPT (p < 0.001). In the MPT- and GP-groups a decrease in the use of short acting opioids was observed (p < 0.01). No change in use of analgesics was seen in the Wt-group. The study showed that (i) in the MPT-group there was a significant reduction in pain intensity and improvement of HRQL compared to the WL-group and (ii) the mere establishment of a pain diagnosis and a pain management plan by a pain specialist was not sufficient to enable the referring GP to manage severely chronic pain patients.
|