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Establishment of a liaison clinic for patients with intractable chronic pain

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

A multidisciplinary approach has been shown to be effective for the treatment of intractable pain. However, few hospitals in Japan have established liaison clinics for such patients. In this study, we investigated the short-term results of a liaison clinic for patients with intractable chronic pain.

Methods

Study participants comprised 53 outpatients (20 men, 33 women) with intractable chronic pain who visited our hospital between April 2012 and March 2013. At baseline, patients completed a self-reported questionnaire and provided demographic and clinical information. Experts in various fields (anesthesia, orthopedic surgery, psychiatry, physical therapy, and nursing) conducted examinations of patients and attended a weekly conference during which patients' physical, psychological, and social problems were discussed and courses of treatment were determined. All patients were assessed using the Numerical Rating Scale (NRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Pain Disability Assessment Scale (PDAS). Eligibility for the pain liaison outpatient clinic was evaluated using multiple logistic regression analysis.

Results

After a 6-month follow-up period, no significant changes were seen in scores for the NRS, PDAS, or HADS for depression. In contrast, scores for both the PCS and HADS for anxiety were significantly reduced after 6 months of treatment (p < 0.05). HADS for anxiety was identified as a factor related to patient resistance to attending the pain liaison outpatient clinic (p < 0.05).

Conclusions

This liaison clinic for patients with intractable chronic pain was able to improve patient anxiety. Severe anxiety at the initial visit represented a risk factor for dropout from the clinic.

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Acknowledgments

No grants were received in support of this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama, 700-8558, Japan

    Tomoko Tetsunaga, Tomonori Tetsunaga & Toshifumi Ozaki

  2. Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Okayama, 700-8558, Japan

    Hiroyuki Nishie

Authors
  1. Tomoko Tetsunaga
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  2. Tomonori Tetsunaga
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  3. Hiroyuki Nishie
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  4. Toshifumi Ozaki
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Corresponding author

Correspondence to Tomonori Tetsunaga.

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Tetsunaga, T., Tetsunaga, T., Nishie, H. et al. Establishment of a liaison clinic for patients with intractable chronic pain. J Orthop Sci 20, 907–913 (2015). https://doi.org/10.1007/s00776-015-0748-y

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  • DOI: https://doi.org/10.1007/s00776-015-0748-y

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