• Pain Med · Jan 2010

    Patient-centered perspective on treatment outcomes in chronic pain.

    • Erin M O'Brien, Roland M Staud, Alisa D Hassinger, Robert C McCulloch, Jason G Craggs, James W Atchison, Donald D Price, and Michael E Robinson.
    • Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA.
    • Pain Med. 2010 Jan 1; 11 (1): 6156-15.

    ObjectiveTo define patient-determined success criteria for fibromyalgia and back pain treatment across four outcome domains: pain, fatigue, emotional distress, interference with daily activities.DesignRetrospective correlational clinical sample design.SettingTertiary care clinics at health science center.Patients248 fibromyalgia patients and 52 back pain patients.InterventionsN/A.Outcome MeasuresPatient Centered Outcomes Questionnaire, measures of usual pain intensity and pain unpleasantness.ResultsOverall, for treatment to be considered successful, fibromyalgia patients required pain levels of 3.30 (54% reduction), fatigue levels of 3.08 (60% reduction), distress levels of 2.49 (60% reduction), and interference levels of 2.67 (63% reduction). Comparatively, back pain patients required pain levels of 2.23 (58% reduction), fatigue levels of 2.29 (57% reduction), distress levels of 1.65 (67% reduction), and interference levels of 1.81 (68% reduction). Overall, both fibromyalgia and back pain patients did not expect to meet their criteria for success.ConclusionsResults highlight the importance of assessing the patient's view of successful outcome. Both fibromyalgia and back pain patients appear to have stringent criteria for success that existing treatments are often unlikely to meet. Comparison across groups indicated fibromyalgia patients have higher usual levels of pain, fatigue, distress, and interference. Interestingly, fibromyalgia patients also require greater changes across domains in order to consider treatment successful, despite rating higher levels of pain, fatigue, distress, and interference as successful. Recognizing patients' success criteria and treatment expectations encourages discussion and development of individualized treatment goals, and wider implementation of individualized treatment for chronic-pain populations is encouraged.

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