Journal of clinical epidemiology
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During the past decade, the multidisciplinary pain clinic has become a popular alternative to the traditional treatment of persistent pain. There is, however, little information describing this population of health care users nor the impact this new demand has on utilization of health care services. The objectives of this study were three fold: to develop a profile of the characteristics of patients referred to a specialty pain clinic including their psychosocial adjustment to their condition; to identify predictors of the use of the specialty services; and to estimate the cost of health service utilization. ⋯ In addition, users of specialty pain clinic services generated proportionately less costs in the use of other health services when they were compared to non-users. The importance of social support and meaning of illness variables in predicting psychosocial adjustment to chronic pain is corroborated in this study as is the relevance of the pain clinic cognitive behavioural approach for these problems. In addition, compared to other chronic pain sufferers with similar characteristics, it appears that the use of the pain clinic contains the use of other services and thus has an important economic impact.
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Diseases other than cancer can be progressive and have a terminal phase and many of the philosophies of palliative care are applicable. The case studies emphasize two types of palliation. First, for the patient and that is well recognized and second, palliation for the caregiver which should include provision of respite care.