Impact on Health-Related Quality of Life and Costs of Managing Chronic Neuropathic Pain in Academic Pain Centres: Results from a One-Year Prospective Observational Canadian Study

Author:

Tarride J-E12,Moulin DE3,Lynch M4,Clark AJ4,Stitt L.5,Gordon A6,Morley-Forster PK3,Nathan H7,Smyth C7,Toth C8,Ware MA9

Affiliation:

1. Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Canada

2. Programs for Assessment of Technology in Health (PATH) Research Institute, St Joseph’s Healthcare Hamilton, Hamilton, Canada

3. Departments of Clinical Neurological Sciences & Anesthesia and Perioperative Medicine, Western University, London, Ontario, Canada

4. Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

5. LW Stitt Statistical Services, University of Toronto, Toronto, Canada

6. Wasser Pain Management Centre, University of Toronto, Toronto, Canada

7. Department of Anesthesiology, University of Ottawa, Ottawa, Ontario, Canada

8. Fraser Health, Burnaby, British Columbia, Montreal, Quebec, Canada

9. Department of Family Medicine, McGill University, Montreal, Quebec, Canada

Abstract

BACKGROUND: The management of chronic pain, including neuropathic pain (NeP), is a major public health issue. However, there is a paucity of data evaluating pain management strategies in real-life settings.OBJECTIVE: To inform policy makers about the economic value of managing chronic NeP in academic centres by conducting a subeconomic assessment of a Canadian multicentre cohort study aimed at determining the long-term outcomes of the management of chronic NeP in academic pain centres. Specific questions regarding the economic value of this type of program were answered by a subset of patients to provide further information to policy makers.METHODS: Baseline demographic information and several pain-related measurements were collected at baseline, three, six and 12 months in the main study. A resource use questionnaire aimed at determining NeP-related costs and the EuroQoL-5 Dimension were collected in the subset study from consenting patients. Statistical analyses were conducted to compare outcomes over time and according to responder status.RESULTS: A total of 298 patients were evaluated in the present economic evaluation. The mean (± SD) age of the participants was 53.7±14.0 years, and 56% were female. At intake, the mean duration of NeP was >5 years. Statistically significant improvements in all pain and health-related quality of life outcomes were observed between the baseline and one-year visits. Use decreased over time for many health care resources (eg, visits to the emergency room decreased by one-half), which resulted in overall cost savings.CONCLUSION: The results suggest that increased access to academic pain centres should be facilitated in Canada.

Publisher

Hindawi Limited

Subject

Anesthesiology and Pain Medicine,Neurology

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