Date of Graduation

Summer 8-8-2014

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Background: Roughly 100 million Americans suffer from chronic pain. Individuals with chronic pain frequently experience decreased quality of life due to pain, decline in health, financial burdens with monthly doctor visits, medication expenses and reduced activity in the workforce. Cognitive intervention in an interdisciplinary approach can help patients cope with their pain, improve quality of life, reduce pain medication use, reduce missed workdays and improve their outlook on pain and its impact on their life. Is an adaptation of this approach needed in the outpatient setting with physical therapists and occupational therapists trained in cognitive treatment of illness perceptions in order to provide a more balanced approach to chronic pain management?

Methods: An exhaustive search of available medical literature was conducted using Medline-OVID, CINAHL and Web of Science using the keywords: chronic pain, pain management and perception. The bibliographies of the articles were further searched for relevant sources. The search was then narrowed to include only English language articles. Relevant articles were assessed using GRADE.

Results: Two studies met inclusion criteria and were included in this systematic review. A randomized controlled trial with 156 participants demonstrated a statistically significant difference between intervention and control groups for the change in patient illness perceptions and patient-relevant physical activities. A retrospective study of 280 participants in a group-based, interdisciplinary chronic pain program demonstrated significant pre- and post-treatment improvements in ratings of pain severity, pain intensity, functional limitations, pain catastrophizing and self-efficacy.

Conclusion: Cognitive treatment of illness perception can improve quality of life for chronic pain patients. Pain management specialties and physical therapists can add cognitive treatment to their armamentarium to provide patients with an additional modality to improve patient outcomes and compliance to treatment regimens in both fields.

Keywords: chronic pain, pain management, perception

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