Predicting Completion of a Cognitive-Behavioral Pain Management Program by Initial Measures of a Chronic Pain Patient's Readiness for Change
- 1 December 2000
- journal article
- clinical trial
- Published by Wolters Kluwer Health in The Clinical Journal of Pain
- Vol. 16 (4), 352-359
- https://doi.org/10.1097/00002508-200012000-00013
Abstract
There is a need to identify pretreatment patient indicators, which are predictive of the successful enrollment and completion of chronic pain treatment programs. Recent evidence suggests the Pain Stages of Change Questionnaire can predict enrollment and completion of a 10-session cognitive-behavioral pain management program. The purpose of this study is to determine whether the pretreatment Stages of Change Questionnaire can predict patients who would complete a cognitive-behavioral pain treatment program. Prospective cohort study using logistic regression analyses. Patients referred for a 10-session cognitive-behavioral treatment program at a tertiary care multidisciplinary pain clinic or a community-based specialty clinic. Three hundred chronic pain patients (151 in the tertiary setting and 149 in the community-based setting) participated, with 147 of the patients (49%) completing and 153 (51%) patients not completing the 10-session program. Ten-visit cognitive-behavioral program for chronic pain patients. Completion of program. The Stages of Change Questionnaire scores could predict completion status chi2 (N = 300, 2 df) = 39.7, p <0.001, (goodness-of-fit test chi2 = 5.69, p = 0.68). Those patients completing the program were slightly older and reported higher levels of pain, depression, and disability than did those patients who did not complete. Low "Precontemplation" score remained the best single predictor, as it identified correctly 61% of the cases patients who completed the program and predicted who would drop out in 65% of the cases. The Stages of Change Questionnaire is a potentially useful tool; however, the current scoring method is insufficient to recommend its use as an inclusion or exclusion criterion for enrollment in a cognitive-behavioral program.Keywords
This publication has 36 references indexed in Scilit:
- 'Instilling the strength to fight the pain and get on with life': learning to become an arthritis self-manager through an adult education programme.Health Education Research, 1999
- Integration of Behavioral and Relaxation Approaches Into the Treatment of Chronic Pain and InsomniaJAMA, 1996
- Dysfunctional patients with temporomandibular disorders: Evaluating the efficacy of a tailored treatment protocol.Journal of Consulting and Clinical Psychology, 1996
- Evidence suggesting that health education for self‐management in patients with chronic arthritis has sustained health benefits while reducing health care costsArthritis & Rheumatism, 1993
- Neglected topics in chronic pain treatment outcome studies: determination of successPain, 1993
- Behavioral Management of Chronic Pain and Excess DisabilityThe Clinical Journal of Pain, 1993
- Decreased Clinic Use by Chronic Pain PatientsThe Clinical Journal of Pain, 1991
- Neglected factors in chronic pain treatment outcome studies — referral patterns, failure to enter treatment, and attritionPain, 1990
- An evaluation of a behavioral program for chronic painJournal of Behavioral Medicine, 1982
- A RETROSPECTIVE ANALYSIS OF VARIABLES RELATED TO DURATION OF TREATMENT IN A UNIVERSITY PSYCHIATRIC CLINICJournal of Nervous & Mental Disease, 1970