alexa Prognostic factors for pain relief and functional improvement in chronic pain after inpatient rehabilitation.


Journal of Pain Management & Medicine

Author(s): Fuss I, Angst F, Lehmann S, Michel BA, Aeschlimann A

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Abstract OBJECTIVE: To determine the factors associated with pain relief and improved physical functioning in chronic pain patients during outpatient management in the first 5 months immediately after a standardized inpatient pain management program. METHODS: Prospective cohort study using standardized questionnaires on sociodemographic data, disease outcome, psychosocial factors, change in behavior, and outpatient therapies on discharge from inpatient rehabilitation and during the 5-month follow-up at home (observation period). Stepwise forward multivariate linear regression analysis examined the correlation of these factors with change in pain severity and change in physical functioning. RESULTS: The study included 80.1\% female patients, 90.0\% had at least 1 comorbidity and 62.9\% had chronic pain for≥5 years. On average, pain intensity and depression worsened slightly during the observation period, but the other outcomes remained almost stable. Relief from anxiety (20.7\% explained variance) and low baseline depression (5.5\%) were the most important predictors for pain relief. Relief from anxiety (13.3\%) and low baseline depression (7.1\%) were most strongly associated with functional improvement. CONCLUSIONS: This study found a strong association of change in pain severity and physical functioning with change in baseline level of affective health and coping during the first outpatient management period after inpatient rehabilitation. As a consequence, it may be possible to improve the treatment of chronic pain by therapy of mood and coping. This article was published in Clin J Pain and referenced in Journal of Pain Management & Medicine

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