Featured Research

from universities, journals, and other organizations

Program Helps Improve Management Of Chronic Pain

Date:
March 24, 2009
Source:
JAMA and Archives Journals
Summary:
Patients with chronic pain who took part in a collaborative care intervention that included patient and clinician education and symptom monitoring and feedback to the primary care physician had improvements in pain-related disability and intensity, compared to usual care, according to a new study.

Patients with chronic pain who took part in a collaborative care intervention that included patient and clinician education and symptom monitoring and feedback to the primary care physician had improvements in pain-related disability and intensity, compared to usual care, according to a new study.

Chronic noncancer pain is associated with considerable physical impairment, distress, depression and increased health care use and costs. Many primary care patients report chronic pain, according to background information in the article. Guidelines for chronic pain treatment have been developed, but implementation has been problematic. "Multifaceted, collaborative interventions can promote guideline-concordant care and improve outcomes for chronic conditions in primary care. These interventions, based on the chronic care model, attempt to optimize patient and clinician interactions via education and activation while providing system support, including care management and clinician feedback," the authors write.

Steven K. Dobscha, M.D., of the Portland VA Medical Center, Portland, and colleagues assessed whether a collaborative care intervention would result in improvements in chronic pain–related outcomes, including depression, compared with treatment as usual among 401 patients treated at 5 primary care clinics. Forty-two primary care clinicians were randomized to the assistance with pain treatment intervention group or the treatment as usual group. The patients had musculoskeletal pain diagnoses, moderate or greater pain intensity, and disability lasting 12 weeks or longer and were assigned to the same treatment groups as their clinicians. Assistance with pain treatment included a 2-session clinician education program, patient assessment, education and activation, symptom monitoring, feedback and recommendations to clinicians and facilitation of specialty care.

The researchers found that, through the use of various measurement tools, intervention patients showed significantly greater improvements in pain-related disability and pain intensity compared with treatment as usual patients during a 12-month period. At 12 months, 21.9 percent of intervention patients vs. 14.0 percent of treatment as usual patients demonstrated 30 percent reductions in a measure of pain-related disability.

Compared with treatment as usual patients with depression over 12 months, intervention patients with depression showed significantly greater improvements on a measurement of depression. Intervention patients also reported significantly improved ratings of impression of change at 6 months and 12 months compared with treatment as usual patients.

"Process measures including greater use of adjunctive pain medications and long-term opioids suggest that the intervention contributed to delivery of guideline-concordant care," the researchers write.

"Overall, this study showed that a collaborative care intervention for chronic pain was significantly more effective than treatment as usual across a variety of outcome measures. Although many of the improvements were modest, they may be especially meaningful because patients in our sample were older, had long-standing pain, multiple medical problems, and reported high baseline rates of disability. Our results add to the growing body of literature suggesting that the collaborative care model is effective in improving clinical outcomes and adherence to treatment guidelines across a variety of chronic conditions. Patients in many health care systems and private group practices have limited access to specialty chronic pain services. A primary care–based intervention can have positive effects on pain disability and intensity, and on depressive symptoms," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Dobscha et al. Collaborative Care for Chronic Pain in Primary Care: A Cluster Randomized Trial. JAMA The Journal of the American Medical Association, 2009; 301 (12): 1242 DOI: 10.1001/jama.2009.377

Cite This Page:

JAMA and Archives Journals. "Program Helps Improve Management Of Chronic Pain." ScienceDaily. ScienceDaily, 24 March 2009. <www.sciencedaily.com/releases/2009/03/090324171432.htm>.
JAMA and Archives Journals. (2009, March 24). Program Helps Improve Management Of Chronic Pain. ScienceDaily. Retrieved April 24, 2014 from www.sciencedaily.com/releases/2009/03/090324171432.htm
JAMA and Archives Journals. "Program Helps Improve Management Of Chronic Pain." ScienceDaily. www.sciencedaily.com/releases/2009/03/090324171432.htm (accessed April 24, 2014).

Share This



More Health & Medicine News

Thursday, April 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Big Pharma Braces for M&A Wave

Big Pharma Braces for M&A Wave

Reuters - Business Video Online (Apr. 22, 2014) Big pharma on the move as Novartis boss, Joe Jimenez, tells Reuters about plans to transform his company via an asset exchange with GSK, and Astra Zeneca shares surge on speculation that Pfizer is looking for a takeover. Joanna Partridge reports. Video provided by Reuters
Powered by NewsLook.com
Study Says Most Crime Not Linked To Mental Illness

Study Says Most Crime Not Linked To Mental Illness

Newsy (Apr. 22, 2014) A new study finds most crimes committed by people with mental illness are not caused by symptoms of their illness or disorder. Video provided by Newsy
Powered by NewsLook.com
Hagel Gets Preview of New High-Tech Projects

Hagel Gets Preview of New High-Tech Projects

AP (Apr. 22, 2014) Defense Secretary Chuck Hagel is given hands-on demonstrations Tuesday of some of the newest research from DARPA _ the military's Defense Advanced Research Projects Agency program. (April 22) Video provided by AP
Powered by NewsLook.com
How Smaller Plates And Cutlery Could Make You Feel Fuller

How Smaller Plates And Cutlery Could Make You Feel Fuller

Newsy (Apr. 22, 2014) NBC's "Today" conducted an experiment to see if changing the size of plates and utensils affects the amount individuals eat. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins