Published in:
01-06-2010 | Reports of Original Investigations
The Canadian STOP-PAIN project – Part 1: Who are the patients on the waitlists of multidisciplinary pain treatment facilities?
Authors:
Manon Choinière, PhD, Dominique Dion, MD, Philip Peng, MBBS, Robert Banner, MD, Pamela M. Barton, MD, Aline Boulanger, MD, Alexander J. Clark, MD, Allan S. Gordon, MD, Denise N. Guerriere, PhD, Marie-Claude Guertin, PhD, Howard M. Intrater, MD, Sandra M. Lefort, PhD, Mary E. Lynch, MD, Dwight E. Moulin, MD, May Ong-Lam, MD, Mélanie Racine, PhD(c), Saifee Rashiq, MB, Yoram Shir, MD, Paul Taenzer, PhD, Mark Ware, MBBS
Published in:
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
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Issue 6/2010
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Abstract
Purpose
The Canadian STOP-PAIN Project assessed the human and economic burden of chronic pain in individuals on waitlists of Multidisciplinary Pain Treatment Facilities (MPTF). This article presents the patients’ bio-psycho-social profile.
Methods
A sample of 728 patients was recruited from waitlists of eight university-affiliated MPTFs across Canada. Subjects completed validated questionnaires to: 1) assess the characteristics and impact of their pain; and 2) evaluate their emotional functioning and quality of life (QoL). Follow-up questionnaires were completed by a subgroup of 271 patients three months later.
Results
Close to 2/3 of the participants reported severe pain (≥ 7/10) that interfered substantially with various aspects of their daily living and QoL. Severe or extremely severe levels of depression were common (50.0%) along with suicidal ideation (34.6%). Patients aged > 60 yr were twice as likely to experience severe pain (≥ 7/10) as their younger counterparts (P = 0.002). Patients with frequent sleep problems were more at risk of reporting severe pain (P ≤ 0.003). Intense pain was also associated with a greater tendency to catastrophize (P < 0.0001) severe depressive symptoms (P = 0.003) and higher anger levels (P = 0.016). Small but statistically significant changes in pain intensity and emotional distress were observed over a three-month wait time (all P < 0.05).
Conclusion
This study highlights the severe impairment that patients experience waiting for treatment in MPTFs. Knowing that current facilities cannot meet the clinical demand, it is clear that effective prevention/treatment strategies are needed earlier in primary and secondary care settings to minimize suffering and chronicity.