Outcomes of an Interdisciplinary Pain Management Program: Does Participants' Opioid Status Predict Improvement?

BACKGROUND: Chronic pain is a prevalent and costly illness that affects 1 in 5 Americans. Interdisciplinary pain management programs have demonstrated cost-effectiveness and significant benefits for a variety of chronic pain conditions. Interdisciplinary programs combined with opioid cessation have also demonstrated effectiveness for patients with chronic pain despite tapering opioid dosage.
SUBJECTS: 41 participants who completed a 4-week interdisciplinary pain management program were included in this study.
METHOD: Participants completed measures of pain rating, pain interference, and anxiety at admission and discharge. Oral morphine equivalents were calculated based on a chart review of program completers. Participants were divided into three groups based on opioid status throughout the program (no opioid, decreased opioid, and same opioid).
RESULTS: Participants with a no opioid status significantly improved on pain rating and pain interference scores from admission to discharge (p < .01). Participants with a decreased opioid status significantly improved on pain rating scores (p < .05) but not on pain interference scores from admission to discharge. Participants with a same opioid status did not significantly improve on either pain rating or pain interference scores from admission to discharge. Additionally, a participant status of “same opioid” was a significant predictor of post-pain interference scores where participants in this group could expect to have 5.46 T-score points higher at discharge. Additionally, younger participants were predicted to have higher post-pain interference scores.
DISCUSSION: Participants who had a no opioid or decreased opioid status throughout the program fared better than those who chose to remain on the same opioid dose. These findings indicate that prescription pain relievers may not have the desired effect for patients with chronic pain seeking interdisciplinary treatment. Future research on the impact of prescription pain relievers on potential benefits of an interdisciplinary pain management program is needed.