The Effectiveness of Interdisciplinary Intensive Outpatient Programs in a Population With Diverse Chronic Pain Conditions: A Systematic Review and Meta-Analysis

Bujak, Barbara K; Regan, Elizabeth; Beattie, Paul; Harrington, Shana

doi:10.2217/pmt-2018-0087

Cited by 28 publications

(26 citation statements)

References 57 publications

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“…This program and similar interdisciplinary programs 36 have engaged patients in intensive, daily, several week periods of care which is not a paradigm that can realistically be made available to all persons with chronic pain and co-occurring disorders. 37 A recent study examined three care paradigms offering different intensities of rehabilitative care for chronic low back pain and found that all reduced work sick leave taken in the ensuing 12 months and that there were no differences in quality of life, sociability or personal beliefs between patients completing the different treatment intensities. Intensive residential care is not a realistic model for all patients, 38 given the high costs to individuals and/or third parties.…”

Section: Discussionmentioning

confidence: 99%

<p>Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital</p>

Buono

Savage

Cerrito³

et al. 2020

JPR

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The objective is to report outcomes of an interdisciplinary group-based residential chronic pain recovery program (CPRC), located in a private non-profit psychiatric hospital. The chronic pain program was aimed at treatment and engagement in self-care of both pain and co-occurring disorders in a residential facility that also offered treatment for specific psychiatric disorders. Patients and Methods: A retrospective chart review was conducted that included a convenience sample of 131 patients admitted from March 2012 through August 2017 who completed treatment. An interdisciplinary team of professionals provided psychobehavioral therapy, movement therapies and medication management. Patients completed a battery of psycho-social and demographic questionnaires on admission and before discharge of the program. Results: Significant differences were noted in pain severity, pain interference, depression and anxiety (p<.01) between admission and discharge, and the Chronic Pain Coping Inventory demonstrated significant differences in guarding (p <.001), asking (p =.018), exercise (p <.001), relaxation (p <.001), and pacing (p=.024). Of patients using opioids on admission, at discharge, 37% had tapered and remained off all opioids, 43% were using buprenorphine for opioid use disorder, and 20% continued on analgesic opioids. Conclusion: Treatment was associated with reductions in pain severity and interference, in anxiety and in depression as well as improvements in pain coping. Additionally, there was a reduction in reliance on opioids for pain relief.

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Section: Discussionmentioning

confidence: 99%

<p>Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital</p>

Buono

Savage

Cerrito³

et al. 2020

JPR

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“…Meta-analyses have established pain rehabilitation programs as an effective treatment option for reducing chronic pain and associated disability (Bujak, Regan, Beattie, & Harrington, 2019; Kamper et al, 2015; Semrau et al, 2015). Multidisciplinary pain management programs were available as early as the 1950s, when Dr. John J. Bonica opened the first multidisciplinary pain clinic to improve functional outcomes for patients with chronic pain (Tompkins, Hobelmann, & Compton, 2017).…”

Section: Pain Rehabilitation Programsmentioning

confidence: 99%

“…A growing body of literature continues to demonstrate that pain rehabilitation programs improve physical functioning, pain severity, and mood among patients with chronic pain (Bailey, Kurklinsky, Sletten, & Osborne, 2018; Hooten, Townsend, Sletten, Bruce, & Rome, 2007), along with a significant reduction in medical costs (Sletten, Kurklinsky, Chinburapa, & Ghazi, 2015). A recent systematic review of a total of 3,370 patients found that interdisciplinary, intensive outpatient pain rehabilitation programs contributed to clinical improvements in pain, mood, pain catastrophizing, and QOL, with large effect sizes (Bujak et al, 2019). Impressively, there is even evidence that improvements in functioning are sustained up to 13 years later (Patrick, Altmaier, & Found, 2004).…”

Section: Pain Rehabilitation Programsmentioning

confidence: 99%

Pain rehabilitation’s dual power: Treatment for chronic pain and prevention of opioid-related risks.

Crouch

Wedin

Kilpatrick

et al. 2020

American Psychologist

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The purpose of this article is to provide a data-driven exploration of an interdisciplinary pain rehabilitation program (PRP) as a viable option for addressing the dual crises of chronic pain and opioid use. Psychologists are crucial providers in the PRP, in both intervention and leadership roles. There is well-established literature supporting pain rehabilitation as an effective treatment for chronic pain and functioning, but there are few studies examining the effects of pain rehabilitation on opioid misuse risk. We evaluated data from 60 patients with diverse chronic pain conditions who completed an interdisciplinary PRP to evaluate changes in pain, functioning (self-report and objective physical measure), psychological symptoms, and health-related quality of life. To evaluate the effect of pain rehabilitation on opioidrelated risks, we examined opioid use and opioid misuse behaviors (measured by the Current Opioid Misuse Measure; COMM) pre-and posttreatment. Results demonstrated statistically significant improvements in all outcomes, with medium effect sizes for pain severity and large effect sizes for functioning, psychological symptoms, and emotional quality of life. Fifty-eight percent of patients were on opioid medications at entry compared with 15% at discharge. Among patients who entered on opioids, mean COMM scores were significantly reduced from above the cutoff for misuse risk (M ϭ 13.57) to below the cutoff (M ϭ 5.86). Overall, this study provided strong support for pain rehabilitation as an effective treatment for chronic pain and related suffering, while also providing a prevention-based opportunity for reducing opioid-related risk. Public Significance StatementThis study supports the dual power of multidisciplinary pain rehabilitation as a viable intervention to address the dual crises of chronic pain and opioid-related risks. Additionally, it highlights the key role of health psychologists on pain rehabilitation teams.

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“…Although healthcare practice in Malaysia has improved over the previous decades, it is predominated by hierarchy working and working in-silo culture [ 15 , 16 ]. Hence, working with various disciplines was found to have a positive impact on clients in a holistic manner which is beyond than just related to the condition [ 17 , 18 ]; for example, chronic pain clients not only received management on the pain but also had a better outcome on physical functions, mental health, emotion, and social and quality of life. Healthcare practitioners need to acknowledge the role of each other for the benefit of the client.…”

Section: Introductionmentioning

confidence: 99%

The Perception of Allied Health Professionals on Occupational Therapy

Yunus

Ridhuwan

Romli

2022

Occupational Therapy International

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Occupational therapy is a client-centered health profession and is a part of an interdisciplinary team. Effective interdisciplinary practice occurs when each professional understands the role of another professional in the team. This resulted in optimal referral among the professionals that can benefit the clients to receive good care and service. However, it seems that referrals to occupational therapy are becoming lesser by day in specific settings and hospitals in Malaysia. This brings a perspective if other professions in the healthcare team understand the role of occupational therapists. This study is aimed at exploring the perception and misconceptions of allied health professionals on the roles of occupational therapists. A focus group discussion was conducted among seven allied health professionals using a heuristic approach. The interview data were analyzed thematically. Themes developed were (i) awareness of occupational therapy ecosystem, (ii) in cooperating togetherness for the benefit of the client, and (iii) addressing the limitation to enhance the occupational therapy visibility. Findings found that the knowledge of other healthcare practitioners and clients on the occupational therapist’s role is still limited. Role confusion and overlapping are common among other allied health professionals. Occupational therapy needs to continually promote the profession’s role and identity for the maximum benefit to the client and overall improvement.

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The Effectiveness of Interdisciplinary Intensive Outpatient Programs in a Population With Diverse Chronic Pain Conditions: A Systematic Review and Meta-Analysis

Cited by 28 publications

References 57 publications

<p>Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital</p>

<p>Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital</p>

Pain rehabilitation’s dual power: Treatment for chronic pain and prevention of opioid-related risks.

The Perception of Allied Health Professionals on Occupational Therapy

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