PsA is associated with a considerable psychosocial burden and new assessment tools, specific to PsA, have been developed to help quantify this burden in patients. Future management algorithms of PsA should incorporate appropriate assessment and management of psychological and physical concerns of patients. Furthermore, patients with PsA should be managed by a multidisciplinary team that works in coordination with the patient and their family or caregivers.

ObjectiveThe Institute of Medicine and the draft National Pain Strategy recently called for better training for health care clinicians. This was the first high-level needs assessment for pain psychology services and resources in the United States.DesignProspective, observational, cross-sectional.MethodsBrief surveys were administered online to six stakeholder groups (psychologists/therapists, individuals with chronic pain, pain physicians, primary care physicians/physician assistants, nurse practitioners, and the directors of graduate and postgraduate psychology training programs).Results1,991 responses were received. Results revealed low confidence and low perceived competency to address physical pain among psychologists/therapists, and high levels of interest and need for pain education. We found broad support for pain psychology across stakeholder groups, and global support for a national initiative to increase pain training and competency in U.S. therapists. Among directors of graduate and postgraduate psychology training programs, we found unanimous interest for a no-cost pain psychology curriculum that could be integrated into existing programs. Primary barriers to pain psychology include lack of a system to identify qualified therapists, paucity of therapists with pain training, limited awareness of the psychological treatment modality, and poor insurance coverage.ConclusionsThis report calls for transformation within psychology predoctoral and postdoctoral education and training and psychology continuing education to include and emphasize pain and pain management. A system for certification is needed to facilitate quality control and appropriate reimbursement. There is a need for systems to facilitate identification and access to practicing psychologists and therapists skilled in the treatment of pain.

This study demonstrates the utility of treating sleep problems in patients participating in an interdisciplinary chronic pain rehabilitation program. Results highlight the benefits of accounting for individual variability in the pain-sleep relationship in a clinical setting and targeting sleep interventions for those individuals whose pain and sleep problems are comorbid.

Study Design. This is an observational cohort study. Objective. The aim of this study was to compare the effectiveness of PT to an interdisciplinary treatment approach in patients with chronic low back pain (CLBP). Summary of Background Data. CLBP is a costly and potentially disabling condition. Physical therapy (PT), cognitive behavioral therapy, and interdisciplinary pain programs (IPPs) are superior to usual care. Empirical evidence is lacking to clearly support one treatment approach over another in patients with CLBP. Methods. One hundred seventeen adult patients who completed an IPP for individuals with ≥3 months of back pain were compared to 214 adult patients with similar characteristics who completed PT. The Modified Low Back Pain Disability Questionnaire was the primary outcome measure. Additional measures included: PROMIS physical function, global health, social role satisfaction, pain interference, anxiety, fatigue, sleep disturbance, and Patient Health Questionnaire. Patients who completed the IPP were matched by propensity score to a historical control group of patients who completed a course of PT. Change in functional disability was compared between IPP patients and matched controls. Patient-reported outcome measures were assessed pre to post participation in the IPP using paired t test and by calculating the proportion with clinically meaningful improvement. Results. Propensity score matching generated 81 IPP and 81 PT patients. Patients enrolled in the IPP had significantly greater improvement in MDQ scores upon completion compared to patients in PT (15.8 vs. 7.1, P < 0.001). The majority of IPP patients reached the threshold for clinically meaningful change of ≥10 point reduction (60.5%) compared to 34.6% of PT patients, P < 0.01. Patients in the IPP also showed statistically and clinically significant improvement in social role satisfaction, fatigue, and sleep disturbance. Conclusion. CLBP patients in an IPP demonstrated greater functional improvements compared to similar patients participating in PT. Level of Evidence: 3