Pain catastrophizing predicts dropout of patients from an interdisciplinary chronic pain management programme: A prospective cohort study
Janke Oosterhaven, Harriet Wittink, Jos Dekker, Cas Kruitwagen, Walter Devillé
Research Group Lifestyle and Health , University of Applied Sciences Utrecht, 3584 CS Utrecht, The Netherlands. E-mail: email@example.com
Objective: To explore predictors of dropout of patients with chronic musculoskeletal pain from an interdisciplinary chronic pain management programme, and to develop and validate a multivariable prediction model, based on the Extended Common-Sense Model of Self-Regulation (E-CSM).
Methods: In this prospective cohort study consecutive patients with chronic pain were recruited and followed up (July 2013 to May 2015). Possible associations between predictors and dropout were explored by univariate logistic regression analyses. Subsequently, multiple logistic regression analyses were executed to determine the model that best predicted dropout.
Results: Of 188 patients who initiated treatment, 35 (19%) were classified as dropouts. The mean age of the dropout group was 47.9 years (standard devition 9.9). Based on the univariate logistic regression analyses 7 predictors of the 18 potential predictors for dropout were eligible for entry into the multiple logistic regression analyses. Finally, only pain catastrophizing was identified as a significant predictor.
Conclusion: Patients with chronic pain who catastrophize were more prone to dropout from this -chronic pain management programme. However, due to the exploratory nature of this study no firm conclusions can be drawn about the predictive value of the E-CSM of Self-Regulation for dropout.
Interdisciplinary pain management programmes have high dropout rates. Patient dropout from these programmes is associated with poor treatment outcomes and high financial costs for society. To improve the overall effectiveness of these programmes more insight is needed into predictors of dropout. This study explored whether patient beliefs (emotional and cognitive) about illness and treatment are related to dropout. The results revealed that patients with chronic pain who catastrophize were more prone to dropout.
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