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Effective Health Care Program

  • July 26, 2010
    Topic Initiated
  • July 28, 2010
  • Sept. 30, 2011
    Technical Brief
  • Jan. 4, 2012
    Disposition of Comments Report

Multidisciplinary Pain Programs for Chronic Noncancer Pain

Technical Brief

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Archived: This report is greater than 3 years old. Findings may be used for research purposes, but should not be considered current.

Structured Abstract

Background

Chronic noncancer pain affects millions of Americans, seriously impacting their quality of life and costing billions of dollars every year in health care expenditures and lost productivity. There are currently no definitive cures for the most prevalent chronic pain syndromes. Multidisciplinary Pain Programs (MPPs) follow a model of care that emphasizes, when pain cannot be successfully eliminated, managing the pain to the extent that the patient's independence is restored and overall quality of life improved.

Purpose

The purpose of this report is to describe the literature and identify important issues and gaps in the evidence base assessing MPPs for the treatment of chronic noncancer pain.

Methods

A review of the published literature and interviews with key informants were conducted

Findings

MPPs have been extensively documented in the standard medical literature. The 183 papers considered in this Technical Brief followed a biopsychosocial model of chronic pain, including treatment components in each of four areas: medical, behavioral, physical reconditioning, and education. Most of the studies were observational before-after designs. Although several different clinical conditions were studied, 90 percent of the studies included chronic back pain, the most frequent condition addressed in the literature. Differences were apparent between studies based in the United States and those in Europe; recent European studies were more likely than U.S. studies to include inpatient delivery of MPP treatment. Declining access to MPP treatment in the United States is highlighted as a key issue faced by those in the community of chronic pain sufferers and researchers.