Predicting treatment compliance following facial pain evaluation

The purpose of this study was to document compliance to treatment follow-up for facial pain patients referred for outside services, In addition, we ge nerated a multidimensional model of the psychosocial constructs associated with chronic pain to determine whether these factors were predictive of com pliance across recommended therapy modalities or with an overall measure of compliance. These constructs included pain report, depressive symptoms, an xiety, cognitive coping strategies, and physical activity reduction. The sa mple consisted of 80 facial pain patients evaluated at a tertiary care, fac ial pain clinic at a large university medical center. Compliance ratings ra nged from 93% to 50% and are consistent with the literature that indicates that compliance differs across treatment modality. Furthermore, compliance rates were lower for the more nontraditional facial pain treatments perform ed by physical therapists or psychologists. Depression was negatively assoc iated with compliance to medication changes, therapeutic injections, and sp lint therapy, but not psychological counseling or physical therapy. Increas ed pain was only associated with physical therapy. Measures of psychologica l distress (depression and anxiety) and pain were predictive of the overall measure of compliance. These results suggest that psychological distress c an be a barrier for positive patient outcomes through reduced treatment com pliance.