Predictors of Success Across Differing Interdiscilinary Pain Programs: Who Benefits from Which Treatment?

Abstract

This study aimed to examine predictors of completion and success in interdisciplinary treatment for chronic pain and to provide clinicians with relevant information in determining the appropriate treatment intensity for patients. A total of 1,062 patients were examined who participated in one of three different levels of treatment intensity: a 120 hour treatment program (n=699), a 72 hour treatment program (n=61), and a 24 hour treatment program (n=302). Results indicated that higher levels of anxiety and greater number of visits to the emergency room in the twelve months prior to treatment were predictive of premature termination of treatment in the more intensive program. For less intensive programs, number of hours resting per day was predictive of early termination of treatment. Predictors of success were then examined utilizing five definitions of success. No single measure was found to be a significant predictor across all five domains. However, lower levels of health care utilization, higher levels of affective distress, greater perceived interference from pain, and lower levels of perceived control were predictive of successful outcomes. Overall, the findings indicate that individuals with greater dysfunction at treatment entry will benefit more from treatment. When comparing three programs of different intensities, the most intensive program produced a higher proportion of successful outcomes. Pre-treatment variables were explored as a means of identifying relevant clinical variables that could be utilized by clinicians to identify the most appropriate treatment program for patients. Greater number of hours resting and higher levels of pain at pre-treatment were found to be useful variables. Namely, those resting more than seven hours per day or reporting pain levels higher than six out of twelve indicated a need for the most intensive program.