Global impressions versus validated measures of treatment effectiveness inpatients with chronic nonmalignant pain

This study compared global impressions of improvement with validated indice s of treatment outcome in patients with chronic nonmalignant pain and explo red 2 factors that might mediate reports of improvement: patient status at follow-up and secondary financial gain. Information concerning pain intensi ty, disability behavior, and secondary financial gain was obtained from 148 patients at intake and from 42 patients at follow-up (a minimum of 6 month s postintake). It was found that patients evidenced significantly diminishe d pain and disability at follow-up. However, patients failed to acknowledge that improvement had occurred on a global impressions measure. Of the vali dated outcome measures, only reduction in pain intensity was associated wit h patient status at follow-up, and only number of disability days was assoc iated with the presence of secondary financial gain. These findings suggest that health care professionals and researchers who rely on global measures of improvement may fail to detect important changes in patient functioning .