1.Retrospective Review of Outcomes of a Multimodal Chronic Pain Service in a Major Teaching Hospital: A Preliminary Experience in Universiti Sains Malaysia
Nizar Abdul Jalil ; Zaharah Sulaiman ; Mohamed Saufi Awang ; Mohamarowi Omar
Malaysian Journal of Medical Sciences 2009;16(4):55-65
Background: Chronic pain is a common medical issue. Beside chronic devastating pain, patients
also suffer dysfunction more generally, including in the physical, emotional, social, recreational,
vocational, financial, and legal spheres. Integrated multidisciplinary and multimodal chronic pain
management programmes offer clear evidence for relief of suffering and return to functional lifestyles.
Materials and Methods: This retrospective review was performed in order to evaluate one-year
outcomes among all newly referred patients of the multimodal chronic pain service at Hospital Universiti
Sains Malaysia (HUSM). All patients received multimodal pain therapy, including pharmacological,
physical, and psychological therapy, exercise, and pain intervention. The variables evaluated were
based on a patient’s global pain assessments, which were made using the Visual Analogue Scale (VAS)
and Oswestry Disability Index (ODI), modified by patient self-report, and were taken within days to
months of commencing our multimodal pain regime.
Results: A total of 169 patients were enrolled in this study. Out of this number, 102 (60.4%)
were seen at the pain clinic, and 67 (39.6%) were referred while they were inpatients. About one-third
of the patients had chronic pain due to cancer. Our data showed that 128 (75.7%) of our chronic pain
patients were successfully managed when ≥50% of pain relief (as measured by their VAS score) was
achieved at any point during the course of the study period. In addition, 104 patients (61.5%) showed
improvement in their modified ODI by 50% or more.
Conclusion: A multimodal chronic pain service plays a significant role in managing chronic pain
patients in a major hospital, as it is capable of delivering comprehensive and attainable care to manage
refractory and intractable chronic pain.