[Effectiveness of an individualized multimodal treatment of chronic pain patients : A retrospective real-life analysis with 3-year follow-up]. / Effektivität einer individualisierten, multimodalen Behandlung bei chronischen Schmerzpatienten : Eine retrospektive Real-life-Analyse mit Follow-up nach 3 Jahren.

BACKGROUND: Chronic pain is a worldwide problem of healthcare along with social and economic factors. The Center for Pain Medicine (CPM) Nottwil offers individualized, interdisciplinary, multimodal pain rehabilitation based on the biopsychosocial approach. The aim of this study was to obtain a real-life analysis of chronic pain patients who were treated at the CPM Nottwil, to understand how they were treated and to analyze the long-term effects of the treatment. METHODS: In a retrospective cohort study data of all patients who underwent a first medical examination at the CPM Nottwil in 2011 were included in the study. The effectiveness of the treatment was analyzed in a 3-year follow-up measurement. The main outcome was the general well-being of the patient. RESULTS: In 2011, 628 chronic pain patients underwent a first medical examination at the CPM Nottwil. They showed low values in the dimension of general well-being and a high impairment due to severely limiting pain intensity. Although the power analysis suggested a sample size of 170 patients for the follow-up measurement, only 46 participants (responders) were included in the final analysis. Baseline characteristics between responders and non-responders of the follow-up-group showed statistically significant differences for health-related quality of life (SF-12) and the anxiety and depression scale (HADS), but not for other sample characteristics. Improvement from pretreatment to follow-up emerged in the dimension of well-being, physical well-being and pain intensity. At follow-up 30% reported being pain-free. CONCLUSION: Individualized, interdisciplinary, multimodal and mostly outpatient pain programs are an effective treatment for patients suffering from chronic pain in the long term. For the first time this effect has been proven in a clinically representative cohort. Limitations of this study are low response rates in the follow-up group and differences in baseline characteristics (anxiety, depression and quality of life) between responders and non-responders.