The DOI matches its Crossref record; 156 of the 156 references it cites were found in a registry or an index.
Neglected topics in the treatment of chronic pain patients — relapse, noncompliance, and adherence enhancement
Abstract
Although published treatment outcome studies for chronic pain have provided favorable support for the efficacy of many pain clinics and the use of specific modalities such as biofeedback and relaxation, there are several factors that mitigate against euphoria. Two related factors that influence interpretation of these reported outcomes are discussed, namely, noncompliance with therapeutic recommendations during treatment and subsequent to treatment termination, and relapse. Conceptual and methodological problems for establishing the prevalence of noncompliance and relapse are reviewed. Several factors that contribute to noncompliance (individual differences, nature of disease or injury, characteristics of the prescribed treatment regimen, health-care provider-patient relationship, and contextual) are discussed. The literature reveals that noncompliance with treatment regimens is quite prevalent across diverse treatment modalities and pain syndromes. The incidence of relapse following initially successful treatment of persistent pain also appears to be high, ranging from 30% to 60%. Studies on arthritis and heterogeneous pain clinic populations suggest that noncompliance and relapse are related; however, this association is less well established for headache patients. Strategies for assessing compliance (i.e., self-report, behavioral, biochemical, and clinical outcome) and the perspectives' of patients and health-care providers on the application of self-care recommendations are discussed. Strategic planning and adherence enhancement tactics to facilitate maintenance of post-treatment gains are described.
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In the citing paper
“It has been indicated that for 30-60% of patients participating in pain management programs, the treatment gain is not maintained long-term (at 1- to 5-year follow-ups) [8,10].”
In the citing paper
“The short-term effects are well established, but concerns about the long-term effects have been raised [7-11].”
In the citing paper
“Few studies have examined home-delivered interventions that aim to support self-management of chronic pain following rehabilitation [11-13].”
In the citing paper
“However, relapse of symptoms is not uncommon [8,11,12] because self-management can be challenging due to the nature of the symptoms.”
In the citing paper
“Nevertheless, the results of the long-term effects of multidimensional pain programs are inconclusive and the need for maintenance support has been clearly stated [65,8,11,12].”
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Metadata
- Authors
- Turk, D. C., & Rudy, T. E.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Turk, Dennis C.
- Venue
- Pain
- Published
- 1991-01
- Volume
- 44
- Issue
- 1
- Pages
- 5-28
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2033451235
- Cited by
- 311
- References
- 154
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 8 · 2020: 13 · 2019: 8 · 2018: 9 · 2017: 8 · 2016: 4 · 2015: 4 · 2014: 4 · 2013: 8 · 2012: 15
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ar038698-07, 5r01de007514-14)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (2R01AR38698)
- National Institute of Dental and Craniofacial Research (2R01DE07514)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- chronic pain, relapse, treatment non-adherence, medication adherence, pain clinic, biofeedback, relaxation training, healthcare provider-patient relationship, self-care, headache, arthritis
- MeSH terms
- Chronic Disease, Humans, Pain, Patient Compliance, Recurrence, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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