Pain Rehabilitation: Patient Centered Outcomes

描述（由申请人提供）：慢性疼痛的极高的个人和经济成本使其成为最紧迫的健康问题之一。尽管一些治疗的有效性得到了经验支持，但慢性疼痛状况的患病率继续上升。我们认为，尽管有经验验证的治疗方法，患者仍继续寻求治疗的一个原因是，疼痛治疗研究中通常采用的结局指标和成功标准不是患者定义的，也没有评估临床相关性。本项目的目的是从患者的角度比较疼痛治疗结果与传统的治疗结果。在多个领域（疼痛强度、负面影响、功能）获得以患者为中心的明确治疗成功评估，将有助于确定更具临床相关性的治疗成功。我们将直接比较传统的结局指标，并将这些指标与以患者为中心的临床相关结局进行常规统计学比较。我们将采用一些创新的测量方法来解决两种类型的慢性疼痛治疗的结果和成功：认知行为康复和口服阿片类药物治疗。我们将评估关于这些治疗如何影响多个治疗领域的成功标准变化的具体假设。在纵向设计中，将通过以患者为中心的自我报告评估治疗结局/成功：疼痛强度、负面影响和功能。还将通过身体表现指标评估身体功能。该项目的结果将提供更多的疼痛治疗成功的临床相关评估，更好地定义这些治疗的共同效应量（即，NNT），并将提供有关定制治疗的初步数据。这些数据也将提高我们对认知行为治疗和口服阿片类药物治疗慢性疼痛的机制的理解。

DESCRIPTION (provided by applicant): The extremely high personal and financial costs of chronic pain make it one of the most pressing health issues. Despite empirical support for the efficacy of some treatments, the prevalence of chronic pain conditions continues to rise. We propose that one reason that patients continue to seek treatment, despite availability of empirically validated treatments is that the outcome measures and success criteria typically employed in pain treatment studies are not patient defined, and do not assess clinical relevance. The purpose of this project is to compare pain treatment outcome from the perspective of the patient with traditional measures of treatment outcome. Obtaining patient centered and defined treatment success assessments across multiple domains (pain intensity, negative affect, function) will allow for a more clinically relevant determination of treatment success. We will make direct comparisons of traditional outcome measures and nomothetic statistical comparisons of those measures with patient centered, clinically relevant outcomes. We will employ a number of innovative measurement approaches to address the outcome and success of two types of treatment for chronic pain: cognitive-behavioral rehabilitation, and oral opioid treatment. We will assess specific hypotheses about how these treatments influence change in success criteria across multiple treatment domains. In a longitudinal design, treatment outcome/success will be assessed via patient centered self report of: pain intensity, negative affect, and function. Physical function will also be assessed with physical performance measures. Results of the project will provide more clinically relevant assessment of pain treatment success, better definition of common effect sizes for these treatments (ie. NNT) and will provide preliminary data on the tailoring of treatments. These data will also improve our understanding of the mechanisms underlying Cognitive-Behavioral Treatments and Oral Opioid Treatment of chronic pain conditions.