Chronic pain patients can be classified into four groups: Clustering-based discriminant analysis of psychometric data from 4665 patients referred to a multidisciplinary pain centre (a SQRP study)

Abstract

ObjectiveTo subgroup chronic pain patients using psychometric data and regress the variables most responsible for subgroup discrimination.DesignCross-sectional, registry-based study.Setting and subjectsChronic pain patients assessed at a multidisciplinary pain centre between 2008 and 2015.MethodsData from the Swedish quality registry for pain rehabilitation (SQRP) were retrieved and analysed by principal component analysis, hierarchical clustering analysis, and partial least squares–discriminant analysis.ResultsFour subgroups were identified. Group 1 was characterized by low “psychological strain”, the best relative situation concerning pain characteristics (intensity and spreading), the lowest frequency of fibromyalgia, as well as by a slightly older age. Group 2 was characterized by high “psychological strain” and by the most negative situation with respect to pain characteristics (intensity and spreading). Group 3 was characterized by high “social distress”, the longest pain durations, and a statistically higher frequency of females. The frequency of three neuropathic pain conditions was generally lower in this group. Group 4 was characterized by high psychological strain, low “social distress”, and high pain intensity.ConclusionsThe identification of these four clusters of chronic pain patients could be useful for the development of personalized rehabilitation programs. For example, the identification of a subgroup characterized mainly by high perceived “social distress” raises the question of how to best design interventions for such patients. Differentiating between clinically important subgroups and comparing how these subgroups respond to interventions is arguably an important area for further research.

‘A lifebuoy’ and ‘a waste of time’: patients’ varying experiences of multidisciplinary pain centre treatment- a qualitative study

“…One of the most striking experiences described by the informants concerns that they feel left alone after discharge, and these experiences are in line with descriptions from studies on chronic pain treatment provided by other healthcare services [34]. With the chronicity as well as the fluctuating symptoms persons with chronic pain have [35], it is clear that they might need support at irregular intervals over a long period. The question arises regarding which role the pain centre should have in this support and whether they should be open to being contacted when the patients and their everyday providers feel they are experiencing the worst pain trajectory.…”

Moderate and Stable Pain Reductions as a Result of Interdisciplinary Pain Rehabilitation—A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)

“…Hedges’ g, which provides a measure of effect size weighted according to the relative size of each sample, was used for between ES using a calculator (). The absolute effect size was considered very large for values ≥ 1.3, large for values between 0.80–1.29, moderate for values between 0.50–0.79, small for values between 0.20–0.49, and insignificant for values < 0.20 [46].…”

Influences of Sex, Education, and Country of Birth on Clinical Presentations and Overall Outcomes of Interdisciplinary Pain Rehabilitation in Chronic Pain Patients: A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)

“…Hedges'g, the measure of effect size weighted according to the relative size of each sample, was used for between group ES using a calculator. The absolute effect size was considered very large for ≥1.3, large for 0.80-1.29, moderate for 0.50-0.79, small for 0.20-0.49, and insignificant for <0.20 [62]. A recent article of ours presents how MIS was obtained [22].…”