Daniel Szczotkowski, Sandra Meyer-Moock, Thomas Kohlmann, Karin Deppe, Anne Gärtner, Greta Hoffmann, Thomas Isenberg, Gabriele Lindena, Ursula Marschall, Carolin Martin, Beatrice Metz-Oster, Lena Milch, André Möller, Bernd Nagel, Frank Petzke, Anke Preissler, Julia Pritzke-Michael, Leonie Schouten, Katja Schwenk, Catharina Schumacher, Anja Waidner, Ulrike Kaiser
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引用次数: 0
Abstract
Introduction: Patients at risk of developing chronic pain are often significantly impaired in their daily, social and work activities. An early interdisciplinary multimodal assessment (IMA) includes a systematically integrated view of medical, psychosocial and functional factors to direct patients to need-based treatment services. This multicentre, randomised, controlled trial examined the effects of an IMA on preventing chronic pain and improving care for adult patients.
Methods: The intervention group (IG) received an IMA in accordance with standardised guidelines. The control group (CG) was offered a unimodal medical pain assessment (MPA). Data from the Characteristic Pain Intensity (PI) and Disability Score (DS), as primary outcomes, were collected at assessment and 3 and 6 months later together with secondary outcomes (e.g. depression, anxiety, stress, catastrophizing, health-related quality of life).
Results: A total of 620 (68.4%) valid questionnaires were available at the 6-month follow-up. The mean reduction (numerical rating scale, 0-10) in terms of improvement within both groups (IG/CG) was 1.6/1.7 points for PI and 1.9/1.8 points for DS. Most secondary outcomes improved as well. However, the differences between the two groups did not reach statistical significance, although there was a tendency for the IG to have a greater effect on some psychological outcomes. Regarding the recommended treatment approaches, the focus in the IG was more on physical activity and psychological and psychosomatic interventions, whereas in the CG there was also a preference for adjusting the medication.
Conclusions: Both early MPA and IMA seem to have a positive effect on outcomes such as pain intensity, functional limitations and psychological factors for patients at risk of developing chronic pain. We critically reflect on the results of the primary research question by discussing the limitations in detail and conclude that further research should ensure that the control conditions reflect standard care and that the follow-up period is long enough.
Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00015443).
期刊介绍：
Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged.
Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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