Interdisciplinary multimodal pain therapy: does the dose make adifference? : Acomparison from routine clinical care

Abstract

Interdisciplinary multimodal pain therapy (IMPT) is an established treatment for patients with severe chronic pain. Little evidence is available on the role of treatment dosage and, in particular, on the association between the duration of IMPT and treatment outcome. The aim of this retrospective study was to compare the medium-term treatment success of ashort inpatient (SIT, 1week) and along outpatient (LOT, 4weeks) IMPT with acomparable treatment concept and comparable therapy intensity (20 h/week) in patients with severe chronic pain. Patients in both groups completed the German Pain Questionnaire at the beginning and end of IMPT as well as after 3months. Primary outcome measures included pain-related impairment and average pain intensity at follow-up in patients of comparable sex, age as well as pain intensity and impairment at the beginning of the therapy. While both groups initially showed significant treatment effects in pain-related impairment and average pain intensity, LOT patients (n = 32) reported significantly better values in both variables at 3‑month follow-up compared with SIT patients (n = 32). This was due to sustained positive effects in LOT patients and worsening in the SIT group. The results indicate that initial treatment effects can be observed in both treatment settings, but alonger duration of therapy seems to favour the long-term stability of treatment effects.