J Orofac Pain 23 (2009), No. 1 13. Feb. 2009
J Orofac Pain 23 (2009), No. 1 (13.02.2009)
Patient-Centered Outcome Criteria for Successful Treatment of Facial Pain and Fibromyalgia
Stutts, Lauren A. / Robinson, Michael E. / McCulloch, Robert C. / Banou, Evangelia / Waxenberg, Lori B. / Gremillion, Henry A. / Staud, Roland
Aims: To define treatment success from the facial pain and fibromyalgia pain patient perspective across four domains (pain, fatigue, emotional distress, interference with daily activities) through the use of the Patient-Centered Outcomes (PCO) Questionnaire.
Methods: Participants included 53 facial pain (46 women, seven men) and 52 fibromyalgia (49 women, three men) patients who completed the PCO Questionnaire. The PCO assesses four relevant domains of chronic pain: pain, fatigue, distress, and interference in daily activities. Participants rated their usual levels, expected levels, levels they considered successful improvements, and how important improvements were in each of the four domains following treatment. Repeated-measures analyses of variance were performed to determine whether differences existed across domains and across pain groups.
Results: Both groups of participants defined treatment success as a substantial decrease in their pain, fatigue, distress, and interference ratings (all approximately 60%). Fibromyalgia participants reported high levels of pain (mean = 7.08, SD = 2.04), fatigue (mean = 7.82, SD = 1.71), distress (mean = 6.35, SD = 2.46), and interference (mean = 7.35, SD = 2.21). Facial pain participants' ratings of these domains were significantly lower for pain (mean = 5.62, SD = 2.38), fatigue (mean = 5.28, SD = 2.64), distress (mean = 4.34, SD = 2.78), and interference (mean = 4.10, SD = 3.06).
Conclusion: These results demonstrate the high expectations of individuals with facial pain and fibromyalgia regarding treatment of their symptoms. Health care providers should incorporate these expectations into their treatment plans and discuss realistic treatment goals with their pain patients.
Keywords: facial pain, fibromyalgia, patient-centered care, treatment outcome, pain/psychology