THE MULTIDISCIPLINARY PAIN CENTER APPROACH: EFFICACY EVALUATED BY MEANS OF A NO-TREATMENT CONTROL GROUP AND PREDICTION OF SUCCESSFULLY VERSUS UNSUCCESSFULLY TREATED PATIENTS

Only two studies have examined the efficacy of the pain center approach using comparison or control groups. However, neither of these studies used an appropriate no-treatment group as a comparison. In the first phase of this study, the long-term efficacy of a multidisciplinary pain management center was evaluated by comparing 20 treated patients with 20 no-treatment control patients who met the program\u27s entrance criteria, wanted to participate, but could not because they did not have insurance coverage. At 1 to 5 years follow-up, 60% of the treated patients met all of the criteria for success established by Roberts and Reinhardt, while none of the untreated patients did so. Treated patients reported less interference with activities, more uptime, lower pain levels, less depression, and fewer hospitalizations than untreated patients. Also, more treated patients reported being employed, while fewer used either narcotic or psychotropic medications at follow-up compared to untreated patients. In the second phase of the study, pretreatment to follow-up changes are reported for both the treated and untreated groups. Treated individuals reported making significant changes on all variables except their use of non-narcotic medications. Untreated individuals made significant changes related only to the number of pain-related surgeries. In the third phase of the study, receipt of compensation, age, education level, use of psychotropic medications, and the number of pretreatment pain-related surgeries formed a parsimonious set of variables that predicted successful treatment with a hit rate of approximately 70%. Several limitations of the study were noted and discussed. Suggestions were made for further research, emphasizing the need to clarify and standardize baseline and follow-up variables