Do patients with chronic noncancer pain accept treatment of questionable benefit more readily than those who are pain free?

Abstract

The efficacy of some common, questionable chronic pain interventions has been debated and it is unclear why sufferers of chronic noncancer pain agree to receive them. This study attempts to determine if chronic pain sufferers characteristically more readily accept treatment with questionable benefit. This study aims to compare the strength of acceptance or rejection of a hypothetical, mock chronic pain treatment of debatable value by two groups of patients: those reporting chronic noncancer pain and those who are "pain free". A questionnaire proposing a hypothetical treatment for chronic pain was distributed to two groups: Group 1 (n=160), patients attending a chronic pain centre, and Group 2 (n=240), patients attending a family practice centre. Patients were asked to score their "treatment acceptance" using a modified Likert scale. The treatment was based on the risks and benefits of epidural steroids. Ninety-three patients in Group 1 were eligible for inclusion in the "chronic pain" group and 92 patients from Group 2, for the "pain free" group. The median scores were identical at +3; nonparametric testing revealed no significant difference between the groups in their acceptance of the treatment. An analogue study such as this removes the potential bias of clinical interaction with a physician, but lacks some reality. Nonetheless, the results from this study did not support the hypothesis that patients with chronic noncancer pain accept treatment of questionable benefit more readily than those who are "pain free".