Pain management programme for Chinese patients: a 10-year outcome review

Objectives: To review the clinical and social benefits of a pain management programme in Hong Kong. Design: Prospective cohort study. Setting: Tertiary out-patient clinic, Hong Kong. Participants: Patients with chronic non-cancer pain and prolonged (mean, 46 months) psychosocial disability who joined the Comprehensive Outpatient Pain Engagement programme between 2002 and 2012. Intervention: A structured 6-week out-patient pain rehabilitation course designed to improve function and reduce disability, regardless of the cause or severity of pain. Main outcome measures: Social outcomes included return-to-work rate, hospital admissions, and outpatient visits. Physical outcomes included tolerance to sitting and standing. Psychological constructs such as mood, catastrophisation, self-efficacy, quality of life, and perceived performances were used. Each measure was taken before and 1 year after the programme. Results: There was significant increase in return-to-work rate 1 year after commencement of the programme (35% after vs 17% before the programme; odds ratio=3.01), reduction in medical utilisation, and improvement in all physical and psychological measures. Pain intensity, psychological distress, and history of work-related injuries were not related to the likelihood of return to work. Shorter duration of pain and higher physical functioning score in 36-Item Short-Form Health Survey were prognostic indicators. Conclusions: Patients with chronic pain who joined the Comprehensive Outpatient Pain Engagement programme showed significant functional improvement despite the long history of pain.