Large-scale replication of psychological outcomes in a community-based interdisciplinary pain management program

Abstract

ABSTRACT Objective: Interdisciplinary pain management programs (IPMPs) are considered best practice chronic pain treatment. However, IPMPs have sparse evidence for efficacy in community settings. This study sought to replicate previously reported outcomes in a community-based IPMP. Methods: Two chronic pain samples that completed an identical two-week IPMP were compared. Sample 1 was a previously published sample of N=129 adults; Sample 2 was N=400 adults. Measures of anxiety, depression, stress and pain catastrophizing were completed on admission and discharge. Results: Significant group improvements in all outcomes were found in both samples; similar proportions of participants showed either improvement, no change, or deterioration in outcomes. The better powered replication sample showed smaller effect sizes, with medium-sized improvements in depression, stress, and catastrophizing, and a small reduction in anxiety. The proportion of replication sample participants who demonstrated reliable individual improvement was 35% for stress, 26% for depression, 25% for catastrophizing, and 20% for anxiety – similar to the original sample. Conclusions: The replicability of treatment-related gains in two independent samples of a community-based IPMP support its short-term efficacy. The similar patterns of individual responsivity across psychological domains provide scope for further studies to determine predictors of individual responsivity and more cost-effective use of IPMPs. KEY POINTS What is already known about this topic: Chronic pain is a pervasive, disabling and costly condition. Chronic pain is refractory to purely biomedical treatments, such as opioids. Interdisciplinary pain management programs (IPMPs) are considered the optimal treatment approach for individuals who experience chronic pain. What this topic adds: The replicability of outcomes achieved in IPMPs delivered within community practice clinics is not known – this study addressed this evidence gap. Two samples of individuals with heterogeneous chronic pain conditions completed an identical two-week IPMP and demonstrated highly significant group-level improvements across four psychological outcomes. Consistent with previous research, the samples demonstrated similar proportions of individuals who showed either improvement, no change, or deterioration on psychological outcomes, further highlighting the widespread individual variability in responses to pain treatment and necessity for replicated outcomes.