SOCIODEMOGRAPHIC PREDICTORS OF TREATMENT OUTCOME IN CHRONIC NONMALIGNANT PAIN PATIENTS - DO PATIENTS RECEIVING OR APPLYING FOR DISABILITY PENSION BENEFIT FROM MULTIDISCIPLINARY PAIN TREATMENT

The present study investigated the ability of sociodemographic variabl es to predict the short-term effect of multidisciplinary pain treatmen t in 286 chronic non-malignant pain patients consecutively referred to a Danish multidisciplinary pain centre. At inclusion and 3 and 6 mont hs later the patients' pain and health related quality of life (HRQL) was assessed using self-administered questionnaires. Sociodemographic variables measured were: age, gender, educational level, civil status, employment status and disability pension (DP) status. Intensity of pa in was measured using a VAS scale. HRQL was evaluated using the Medica l Outcome Study-Short Form (SF-36) and the Psychological General Well- Being Scale (PGWB). Drop out was 30% after 6 months, leaving 170 patie nts for the study of treatment effects. Among the sociodemographic var iables evaluated only retirement pension (RP) and DF-status seemed to be significant outcome predictors: six months after inclusion, patient s on RP (patients >68 years, n = 40) reported larger pain reduction (3 0 mm on the VAS scale) than patients less than or equal to 68 years (8 mm on the VAS scale)(P = 0.001). Patients applying for DP-pension (n = 26) did not improve. Patients on DP (n = 54) and patients not receiv ing DP (n = 50) obtained moderate improvements, but the improvements w ere significantly larger than the improvements observed in the ApplyDP -group (P = 0.05). The same pattern was seen for changes in psychologi cal well-being (PGWB) and social functioning (SF36-SFA). No improvemen ts were obtained in SF36-Physical functioning scores. DP-status predic ted improvement in pain and social functioning even when controlling f or the effect of other demographic variables, pain intensity and HRQL at referral. The present study indicates that the multidimensional pro blems experienced by patients applying for DP are dominated by socioec onomic factors. Focus on solving these socioeconomic problems is impor tant if chronic pain patients are to benefit from multidisciplinary pa in treatment. (C) 1998 International Association for the Study of Pain . Published by Elsevier Science B.V.