Chronic pain is a significant and costly problem in the United States as well as throughout the industrialized world. Unfortunately, there have been concerns about the effectiveness of traditional medical interventions, suggesting the need for alternative chronic pain treatment strategies. However, the introduction of the biopsychosocial model of pain during the past decade stimulated the development of more therapeutically effective and cost-effective interdisciplinary chronic pain management programs. In the present article we briefly review the history of pain management, discuss the major components of a "true" interdisciplinary pain management program, focus on the evidence-based outcomes that have documented the effectiveness of such interdisciplinary pain management programs, and note the barriers that have blocked the wider use of such programs. Finally, we discuss future directions in interdisciplinary pain management.
Objective: The purpose of this review is to critically examine studies that have examined investigated the Montreal Cognitive Assessment (MoCA) and functional or medical outcomes and other health variables in patients with non-neurologic medical conditions. Method: Databases OVID Medline and Embase were systematically searched through April 2020, yielding 281 articles that were separately screened for inclusion. Study characteristics extracted from retained articles are presented in Table S1 (online supplemental materials). Results: Thirty-six articles were retained. Cognitive impairment as assessed by the MoCA was associated with adverse health variables including increased morbidity/mortality, poorer functional abilities, increased length of hospital stay, and increased hospital readmissions in 34 of 36 articles. Conclusions: Cognitive impairment as detected by the MoCA was shown in 34 of 36 studies to be associated with worse functional or medical status compared to those with better cognitive functioning across a variety of medical populations. Further research is needed to better understand how to best use the MoCA to potentially inform treatment planning in medical populations, including referral for more detailed neuropsychological evaluation.
As chronic pain contributes to tremendous personal and societal costs, efforts at identifying and understanding pain-related disability via the biopsychosocial model have become increasingly important in addressing pain-related health outcomes. This study attempted to compare the predictive ability of the Pain Disability Questionnaire against other established measures in terms of health and pain-related outcomes. The sample consisted of 254 adult chronic pain patients seeking treatment through an interdisciplinary chronic pain management clinic. Participants were administered a battery of assessments including the Pain Disability Questionnaire and other established measures of health and pain-related outcomes (e.g., NIH PROMIS measures) at baseline and post-treatment time points. Results demonstrated convergent validity between the Pain Disability Questionnaire and the other study measures. Hierarchical regression analyses revealed significant associations between painrelated disability as measured by the Pain Disability Questionnaire and a range of biopsychosocial outcomes. Pain Disability Questionnaire scores, as placed in categorical severity levels, demonstrated good discriminative abilities in terms of predicting health-related factors. These findings support the clinical use of the Pain Disability Questionnaire as an empirically supported predictor of health-related outcomes as compared with other established measures of pain and health outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.