Faculty of Medicine and Health Sciences, University of Sherbrooke.
School of Public Administration, University of Victoria, Victoria, BC.
Clin J Pain. 2020 Nov;36(11):833-844. doi: 10.1097/AJP.0000000000000869.
The objective of this study was to evaluate the effectiveness of an intensive interdisciplinary pain treatment (IIPT) day-hospital program as compared with an outpatient multimodal treatment (MMT) for youth with chronic pain.
A nonrandomized pretest posttest with control group design was used. A battery of patient-oriented measures assessing pain interference, quality of life, and depressive symptoms were completed at treatment commencement and at 3, 6, and 12 months after treatment by 44 youths enrolled in the IIPT and 138 youths engaged in the MMT, with various chronic pain conditions. Data were analyzed using longitudinal mixed-effects models.
The main outcomes were the score difference from baseline of patient-oriented measures across 3 timepoints within 12 months of intervention initiation for both treatment groups. IIPT participants demonstrated greater improvement in pain interference, as compared with MMT at 3 and 12 months. Initially, health-related quality of life scores improved similarly in both groups, but greater improvement was seen in the MMT group at 12 months. Depressive symptom scores did not improve with either intervention. Only pain interference scores reached statistically and clinically significant difference levels.
This study supports the benefits of specialized rehabilitation interventions, including both MMT and IIPT programs, for youths with chronic pain. The findings also suggest that IIPT might have a greater long-term effect for helping youths, in particular those with high pain interference scores.
本研究旨在评估强化跨学科疼痛治疗(IIPT)日间医院计划与门诊多模式治疗(MMT)对慢性疼痛青少年的疗效。
采用非随机前后测试对照设计。共有 44 名参加 IIPT 和 138 名参加 MMT 的青少年患有各种慢性疼痛疾病,他们完成了一系列以患者为导向的评估疼痛干扰、生活质量和抑郁症状的措施,这些措施在治疗开始时和治疗后 3、6 和 12 个月进行。使用纵向混合效应模型进行数据分析。
主要结果是干预启动后 12 个月内 3 个时间点内患者导向测量的评分与基线的差异,比较了两组治疗的结果。与 MMT 相比,IIPT 参与者在 3 个月和 12 个月时疼痛干扰的改善更为明显。最初,两组的健康相关生活质量评分都有相似的改善,但 MMT 组在 12 个月时的改善更为明显。两种干预措施都没有改善抑郁症状评分。只有疼痛干扰评分达到了统计学和临床显著差异水平。
这项研究支持了专门的康复干预措施,包括 MMT 和 IIPT 计划,对慢性疼痛青少年的益处。研究结果还表明,IIPT 可能对帮助青少年,特别是那些疼痛干扰评分较高的青少年,具有更大的长期效果。