The association between waiting time and multidisciplinary pain treatment outcomes in patients with rheumatic conditions
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RESEARCH ARTICLE
BMC Rheumatology
Open Access
The association between waiting time and multidisciplinary pain treatment outcomes in patients with rheumatic conditions Simon Deslauriers1,2, Jean-Sébastien Roy1,2, Sasha Bernatsky3,4,5, Debbie E. Feldman6,7,8, Anne Marie Pinard1,2,9, François Desmeules6,10, Mary-Ann Fitzcharles3,4 and Kadija Perreault1,2*
Abstract Background: Access to multidisciplinary pain treatment facilities (MPTF) is limited by extensive waiting time in many countries. However, there is a lack of knowledge about the impact of waiting time on clinical outcomes, particularly for patients with rheumatic conditions. This study examined the association between waiting time for MPTF and clinical outcomes in patients with rheumatic conditions. Methods: Data were extracted from the Quebec Pain Registry, a large database of patients who received services in MPTF. The associations between waiting time (classified as < 2 months, 2–6 months and > 6 months) and change in pain interference, pain intensity and health-related quality of life, from the initial visit at the MPTF to the 6-month follow-up, were tested using generalized estimating equations. Results: A total of 3230 patients with rheumatic conditions (mean age: 55.8 ± 14.0 years; 66% were women) were included in the analysis. Small significant differences in improvement between waiting time groups were revealed, with patients waiting less than 2 months having a larger improvement in all clinical outcomes compared to patients who waited 2–6 months or over 6 months before their initial visit (adjusted time X group effect p ≤ 0.001). Only patients waiting less than 2 months reached a clinically important improvement in pain interference (1.12/10), pain intensity (1.3/10) and physical and mental quality of life (3.9 and 3.7/100). Conclusions: Longer delays experienced by patients before receiving services in MPTF were associated with statistically significant smaller improvements in pain interference, pain intensity and health-related quality of life; these differences were, however, not clinically significant. Based on these results, we advise that strategies are developed not only to reduce waiting times and mitigate their impacts on patients with rheumatic conditions, but also to improve treatment effectiveness in MPTF. Keywords: Waiting time, Clinical outcomes, Rheumatic conditions, Chronic pain, Multidisciplinary pain treatment facilities
* Correspondence: [email protected] 1 Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), 525, boulevard W.-Hamel, Quebec, QC G1M 2S8, Canada 2 Faculty of medicine, Université Laval, CHUL, 2705, boulevard Laurier, #3412, Quebec, QC G1V 4G2, Canada Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropria
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