Abstract
Objectives
This study assessed the utility of the Multidimensional Patient Impression of Change
(MPIC) questionnaire in a pediatric pain population after interdisciplinary treatment.
Design
Observational study with retrospective chart review. The observed treatment program
included psychological counseling, relaxation training, physical therapy, occupational
therapy, and physician management.
Setting
Outpatient pain management center affiliated with an academic rehabilitation hospital.
Participants
A heterogeneous group of pediatric patients with chronic pain (N=202) who completed
an interdisciplinary pain management program.
Interventions
Not applicable.
Main Outcome Measures
Measures assessing pain, mood, development, social functioning, physical functioning,
and family functioning were administered pre- and posttreatment, and the MPIC was
administered posttreatment.
Results
Statistically significant improvements were observed in all outcomes (P<.05). The majority of patients perceived themselves to be improved (minimally to
very much) in all clinical domains of the MPIC, ranging from 60% (medication efficacy)
to 96% (coping with pain). The MPIC ratings were significantly correlated with improvements
in most of the outcome measures. The MPIC domains accounted for more than half of
the unique variance in predictive models when added to the Patient Global Impression
of Change, and most of the variance when added to the models first.
Conclusions
The MPIC was found to be an effective screening tool for assessing patient perceived
progress in a pediatric chronic pain population.
Keywords
List of abbreviations:
BAPQ (Bath Adolescent Pain Questionnaire), IPMP (interdisciplinary pain management programs), MPIC (Multidimensional Patient Impression of Change), PGIC (Patient Global Impression of Change)To read this article in full you will need to make a payment
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References
- The epidemiology of chronic pain in children and adolescents revisited: a systematic review.Pain. 2011; 152: 2729-2738
- Pain, fatigue, and health-related quality of life in children and adolescents with chronic pain.Clin J Pain. 2009; 25: 407-412
- The severity of chronic pediatric pain: an epidemiological study.Pain. 2008; 9: 226-236
- Chronic pain and its impact on quality of life in adolescents and their families.J Pediatr Psychol. 2001; 26: 145-153
- The economic costs of chronic pain among a cohort of treatment-seeking adolescents in the United States.J Pain. 2014; 15: 925-933
- Pain as a global public health priority.BMC Public Health. 2011; 11: 770
- Systematic review on intensive interdisciplinary pain treatment of children with chronic pain.Pediatrics. 2015; 136: 115-127
- Core outcome domains for chronic pain clinical trials: IMMPACT recommendations.Pain. 2003; 106: 337-345
- Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT recommendations.J Pain. 2008; 9: 771-783
- Clinical importance of changes in chronic pain intensity on an 11-point numeric pain rating scale.Pain. 2001; 94: 149-158
- Multidimensional patient impression of change following interdisciplinary pain management.Pain Pract. 2018; 18: 997-1010
- Satisfaction with an intensive interdisciplinary pain treatment for children and adolescents: an independent outcome measure?.Clin J Pain. 2018; 9: 795-803
- Pain assessment methods and interventions used by pediatric psychologists: a survey by the Pain Special Interest Group of the Society of Pediatric Psychology.Prof Psychol Res. 2017; 48: 445-452
- Interdisciplinary pain management improves pain and function in pediatric patients with chronic pain associated with joint hypermobility syndrome.PM R. 2019; 11: 150-157
- Core outcome measures for chronic pain clinical trials: IMMPACT recommendations.Pain. 2005; 113: 9-19
- Three new datasets supporting use of the numerical rating scale (NRS-11) for children’s self-reports of pain intensity.Pain. 2009; 143: 223-227
- Evidence for the use of a numerical rating scale to assess the intensity of pediatric pain.Eur J Pain. 2009; 13: 1089-1095
- Validation and properties of the verbal numeric scale in children with acute pain.Pain. 2010; 149: 216-221
- Psychometric properties of the numerical rating scale to assess self-reported pain intensity in children and adolescents.J Clin Pain. 2017; 33: 376-383
- The Bath Adolescent Pain Questionnaire (BAPQ): development and preliminary psychometric evaluation of an instrument to assess the impact of chronic pain on adolescents.Pain. 2005; 118: 263-270
- Metaanalysis of experiments with matched groups or repeated measures designs.Psychol Methods. 1996; 1: 170-177
- Statistical power analysis for the behavioral sciences.2nd ed. Lawrence Erlbaum Associates, Hillsdale, NJ1988
- A comparison of the relative utility of coping and acceptance-based measures in a sample of chronic pain sufferers.Eur J Pain. 2006; 10: 23-29
- Patients' impression of change following treatment for chronic pain: global, specific, a single dimension, or many?.J Pain. 2015; 16: 518-526
- Contributions of change in clinical status parameters to Patient Global Impression of Change (PGIC) scores among persons with fibromyalgia treated with milnacipran.Pain. 2010; 149: 373-378
Article info
Publication history
Published online: July 15, 2020
Footnotes
Current affiliation for Scholten, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, FL.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
