Pain management program follow-ups. a national survey of current practice in the United Kingdom.

Abstract

In the United Kingdom (UK), the number of multidisciplinary pain management programs (PMP) has sharply increased in the last decade. Treatment aims to effect long-term changes, yet arrangements for evaluating long-term treatment outcome in routine practice remain unknown. All PMPs identified in the UK were invited to provide information by mailed questionnaire on aspects of follow-up evaluation. Sixty-six of 70 PMPs identified were successfully contacted (94% response rate). Ten of 48 PMPs (21%) provided complete data and met suggested criteria for adequate length and rates of follow-up, and outcome measurement. Levels of staffing and content explained only a proportion of the variability seen. A general commitment to follow-up outcome evaluation by PMPs was identified but there was substantial variability among programs in length of follow-up, attendance rates, and outcome measurement. These findings raise issues about the consistency of follow-up evaluation across the UK and the ability of current arrangements in some PMPs to accurately determine the longer-term outcome of chronic pain patients. Incorporating follow-ups into existing desirable criteria and agreeing on core outcome measures are two options available to service providers.