INPATIENT VS OUTPATIENT PAIN MANAGEMENT - RESULTS OF A RANDOMIZED CONTROLLED TRIAL

Inpatient and outpatient cognitive behavioural pain management program mes for mixed chronic pain patients were compared. Patients were rando mly allocated to the 4 week inpatient programme or to the 8 half day p er week outpatient programme, or to a waiting list control group. Staf f, teaching materials, and setting were the same for the two treatment groups. Patients were assessed pre-treatment, and at 1 month after di scharge, and treated patients also at 6 months and 1 year after discha rge, by assessors blind to treatment group; assessments included physi cal, functional and psychological measures, and medication use. In tot al, 121 mixed chronic pain patients (mean age 50 years; mean chronicit y 8.1 years) were included in the study, following medical examination to ensure that no further medical treatment was appropriate. There wa s no change in the control group; inpatients and outpatients, comparab le before treatment, both made significant improvements in physical pe rformance and psychological function, and reduced medication use. Inpa tients made greater gains, and maintained them better at 1 year; they also used less health care than outpatients. There were no outstanding predictors of improvement other than treatment group.