(352) Comprehensive Pain Program initial evaluation in Hawaii: Preliminary study

Abstract

The aim of this study was to provide a preliminary outcome evaluation of the Comprehensive Pain Program (CPP) that was developed to treat chronic pain patients in Hawaii. The CPP is a biopsychosocial intervention designed to interrupt the pattern of social isolation and to reduce pain-related depression that contributes to reducing quality of life, poor function, and increased utilization of resources. Primary elements of the program include group psychotherapy, acupuncture, mind/body training, and therapeutic movement. Additional foci are pain education including education of mechanisms of medications and education of pain mechanisms. Focused attention is given to lifestyle, diet, and risk and benefits of herbs and supplements. 28 participants of three cohorts completed all the procedures (i.e., three sessions a week, each lasting three hours for a 12-week period). The CPP demonstrated success in the four outcome areas (depression, anxiety, quality of life, and functional ability). Post-treatment, patients demonstrated statistically significant decreases in depression (p=.008) and anxiety (p=.016), and statistically significant improvement in quality of life (p=.014). With respect to functional ability, 64% of patients who entered the program were disabled and 90% of these patients were able to return to gainful activity and maintain gainful activity over time. In addition, in terms of utilization of healthcare resources, 81% of patients had reductions in high level opiate use by 50% or more following the program. In conclusion, this preliminary evaluation of the CPP suggests additional studies with a larger sample size and comparison groups are warranted to further evaluate critical components of the treatment package, treatment outcome (e.g., depression, anxiety, and quality of life), and cost-effectiveness (e.g., savings for employers due to reduced absenteeism and for insurance carriers due to less utilization). Supported from HMSA and ZEIR. The aim of this study was to provide a preliminary outcome evaluation of the Comprehensive Pain Program (CPP) that was developed to treat chronic pain patients in Hawaii. The CPP is a biopsychosocial intervention designed to interrupt the pattern of social isolation and to reduce pain-related depression that contributes to reducing quality of life, poor function, and increased utilization of resources. Primary elements of the program include group psychotherapy, acupuncture, mind/body training, and therapeutic movement. Additional foci are pain education including education of mechanisms of medications and education of pain mechanisms. Focused attention is given to lifestyle, diet, and risk and benefits of herbs and supplements. 28 participants of three cohorts completed all the procedures (i.e., three sessions a week, each lasting three hours for a 12-week period). The CPP demonstrated success in the four outcome areas (depression, anxiety, quality of life, and functional ability). Post-treatment, patients demonstrated statistically significant decreases in depression (p=.008) and anxiety (p=.016), and statistically significant improvement in quality of life (p=.014). With respect to functional ability, 64% of patients who entered the program were disabled and 90% of these patients were able to return to gainful activity and maintain gainful activity over time. In addition, in terms of utilization of healthcare resources, 81% of patients had reductions in high level opiate use by 50% or more following the program. In conclusion, this preliminary evaluation of the CPP suggests additional studies with a larger sample size and comparison groups are warranted to further evaluate critical components of the treatment package, treatment outcome (e.g., depression, anxiety, and quality of life), and cost-effectiveness (e.g., savings for employers due to reduced absenteeism and for insurance carriers due to less utilization). Supported from HMSA and ZEIR.