Effect of an interdisciplinary outpatient pain management program (IOPP) for chronic pain patients with and without migration background: a prospective, observational clinical study.

OBJECTIVES: Short- and long-term effects of an interdisciplinary outpatient pain program (IOPP) in terms of quality of life, coping strategies, experiencing of pain and pain intensity as well as the influence of age, gender, or migration background. DESIGN: Single, prospective cohort with assessments at baseline, posttreatment, and at 3, 6, 12 months follow-up. PATIENTS: A total of 175 patients with chronic, nonmalignant pain syndromes (32.1% male and 67.9% female; age 43 ± 9.6 years). INTERVENTION: Multi-professional, biopsychosocial-oriented pain program for the duration of 8 weeks. OUTCOMES: Pain intensity, Pain Disability Index (German Version of Pain Disability Index, PDI-G), cognitive and behavioral coping strategies (Verarbeitung chronischer Schmerzen FESV), Marburger questionnaire about habitual subjective well-being, and processing of chronic pain (Veränderungsfragebogen des Erlebens und Verhaltens, VEV). The migration background was considered to determine whether this variable influences the clinical outcomes. RESULTS: All the mentioned variables except pain intensity improved significantly after the program (P < 0.05); whereas, after the 1-year follow-up, most of the parameters returned to the baseline values. Solely the subscale "pain-related psychological strain" remained significantly better compared with baseline (P < 0.05). The variable "migration background" influenced the outcomes PDI-G, habitual well-being, and FESV (P < 0.001; variance of 16.7% [95% confidence interval 7.8-25.5]). After 12 months, 49.4% showed an improvement with regard to the VEV outcome measurement, 22.6% showed no changes, and 28% showed worsening of the symptoms. Gender and age did not influence the results at 12 months (P = 0.408; P = 0.964). CONCLUSION: This study provides evidence for the short-term effect of the IOPP in chronic pain patients as well as the long-term effect for the variable "pain-related psychological strain".

Pain and psychological health status in chronic pain patients with migration background--the Zurich study.

The objective of this paper is to investigate whether there were differences in pain and psychological health status in chronic pain patients with and without migration background before and after an 8-week interdisciplinary outpatient pain programme (IOPP). One hundred eighteen consecutively assessed patients were included. Pain and psychological health were recorded prior to and after the intervention, and at the 3-, 6- and 12-month follow-up. The migrant group experienced a statistically significant and clinically relevant higher amount of pain and worse psychological functioning than the non-migrant group at all time points. Statistically significant differences between the groups for the variables depression, anxiety, kinesiophobia and passive coping, in particular catastrophizing, were observed in the short and long term. The non-migrant group improved continuously on all outcome measurements at all time points. The results show differences in outcome for chronic pain patients with and without migration background. High pain intensity, high levels of depression, anxiety and catastrophizing at baseline appear to be major barriers for improvement in a sample of migrant patients when participating in an IOPP. Treatments may have to be tailored to the specific needs of this patient group to better address their poor psychological health status and to improve the course of the pain disorder.