Background & Aims

In Japan, multidisciplinary pain management for chronic pain is not covered by national health insurance. To improve this situation, health care professionals are developing categorized multidisciplinary pain centers and testing their usefulness with support from researchers and policy makers. The aim of this study is to examine the differences in treatment response of patients with chronic pain by category of multidisciplinary pain centers in Japan.

Methods

We analyzed 111 of 1,146 patients with moderate to severe pain who visited 15 multidisciplinary pain centers between 2013 and 2021 and were treated for at least 6 months. Pain centers were categorized into three types based on their treatment team system: (category S, n = 37) interdisciplinary, (category A, n = 63) strongly multidisciplinary, and (category B, n = 11) weakly multidisciplinary. Treatment evaluations were conducted at three time points: during the initial visit, and then at three and six months after the initial visit. Patients completed a numerical rating scale (NRS), the Pain Disability Assessment Scale (PDAS), the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS), and the Pain Self-Efficacy Questionnaire (PSEQ). We used a generalized mixed model to estimate the treatment effect at baseline and at three and six months after baseline among three categories of pain centers. Hedges’ g was calculated as the effect size.

Results

Patients who visited pain centers in all three categories showed significant improvement with a high effect size from the first visit to six months. The results comparing the improvement in the adjusted mean scores at three and six months after the first visit with the adjusted mean scores at the first visit (used as reference) showed that all questionnaire scores improved significantly in categories S and A. However, in category B, neither the NRS mean nor the PCS showed significant improvement at three months, and the scores for HADS depression and PSEQ did not show statistically significant improvement at either three or six months.

Conclusions

The findings suggest the effectiveness of multidisciplinary pain centers in Japan, especially those with interdisciplinary and strong multidisciplinary approaches, in significantly improving chronic pain management. The lesser improvement observed in weak multidisciplinary centers suggests the need for stronger collaborative strategies. These findings support the integration of multidisciplinary treatment into Japan’s national health insurance system to improve chronic pain management.

References

none

Presenting Author

Shuichi Aono

Poster Authors

Shuichi Aono

PhD

Tamagawa University

Lead Author

E-mail

Keiko Yamada

Juntendo University

Lead Author

E-mail

Kazuhide Inage

MD

Department of Orthopaedic surgery, Graduate school of Medicine, Chiba University

Lead Author

E-mail

Young-Chang Arai

Multidisciplinary Pain Center, Aichi Medical University

Lead Author

E-mail

Sumihisa Orita

MD

Center for Frontier Medical Engineering (CFME), Chiba University

Lead Author

E-mail

Topics

  • Evidence, Clinical Trials, Systematic Review, Guidelines, and Implementation Science