Interventional Pain Management in Multidisciplinary Chronic Pain Clinics: A Prospective Multicenter Cohort Study with One-Year Follow-Up.

Cláudia Gouvinhas,José Manuel Castro-Lopes,Dalila Veiga,Luís Filipe Azevedo,Rute Sampaio,Liliane Mendonça

doi:10.1155/2017/8402413

Abstract

Background Interventional Pain Management (IPM) is performed in multidisciplinary chronic pain clinics (MCPC), including a range of invasive techniques to diagnose and treat chronic pain (CP) conditions. Current patterns of use of those techniques in MCPC have not yet been reported. Objective We aimed to describe quantitatively and qualitatively the use of IPM and other therapeutic procedures performed on-site at four Portuguese MCPC. Methods A prospective cohort study with one-year follow-up was performed in adult patients. A structured case report form was systematically completed at baseline and six and 12 months. Results Among 808 patients referred to the MCPC, 17.2% had been prescribed IPM. Patients with IPM were on average younger and had longer CP duration and lower levels of maximum pain and pain interference/disability. The three main diagnoses were low back pain (n = 28), postoperative CP, and knee pain (n = 16 each). From 195 IPM prescribed, nerve blocks (n = 108), radiofrequency (n = 31), and viscosupplementation (n = 22) were the most prevalent. Some IPM techniques were only available in few MCPC. One MCPC did not provide IPM. Conclusions IPM are seldom prescribed in Portuguese MCPC. Further studies on IPM safety and effectiveness are necessary for clear understanding the role of these techniques in CP management.

Highlights

Chronic pain (CP) is a worldwide public health problem that causes a substantial burden on healthcare systems and society, taking into account its high prevalence, economic costs, and the quality of life impairment of the patients and their families
For more than twenty years, the International Association for the Study of Pain (IASP) defined chronic chronic pain (CP) as “pain that persists beyond normal tissue healing time, which is assumed to be
We found that nerve blocks were the most frequent Interventional Pain Management (IPM) prescribed in multidisciplinary chronic pain clinics (MCPC); with a total of 420 IPM or Other therapeutic procedures (OTP) prescribed during the one-year follow-up

Summary

Introduction

Chronic pain (CP) is a worldwide public health problem that causes a substantial burden on healthcare systems and society, taking into account its high prevalence, economic costs, and the quality of life impairment of the patients and their families. CP of moderate to severe intensity has been estimated to occur in 19% of European adults and 40% of them reported inadequate management of their pain [8, 11]. Interventional Pain Management (IPM) is performed in multidisciplinary chronic pain clinics (MCPC), including a range of invasive techniques to diagnose and treat chronic pain (CP) conditions. Current patterns of use of those techniques in MCPC have not yet been reported. A prospective cohort study with one-year follow-up was performed in adult patients. Among 808 patients referred to the MCPC, 17.2% had been prescribed IPM. IPM are seldom prescribed in Portuguese MCPC. Further studies on IPM safety and effectiveness are necessary for clear understanding the role of these techniques in CP management

Objectives

Methods

Conclusion