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Inpatient vs. outpatient pain management: results of a randomised controlled trial
Abstract
Inpatient and outpatient cognitive behavioural pain management programmes for mixed chronic pain patients were compared. Patients were randomly allocated to the 4 week inpatient programme or to the 8 half day per week outpatient programme, or to a waiting list control group. Staff, teaching materials, and setting were the same for the two treatment groups. Patients were assessed pre-treatment, and at 1 month after discharge, and treated patients also at 6 months and 1 year after discharge, by assessors blind to treatment group; assessments included physical, functional and psychological measures, and medication use. In total, 121 mixed chronic pain patients (mean age 50 years; mean chronicity 8.1 years) were included in the study, following medical examination to ensure that no further medical treatment was appropriate. There was no change in the control group; inpatients and outpatients, comparable before treatment, both made significant improvements in physical performance and psychological function, and reduced medication use. Inpatients made greater gains, and maintained them better at 1 year; they also used less health care than outpatients. There were no outstanding predictors of improvement other than treatment group.
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“In Analysis 2.2, heterogeneity of 61% was reduced to 54% by the removal of one positive outlier (Williams 1996), but results were essentially unchanged.”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Williams 1996
In the citing paper
“In Analysis 3.2, heterogeneity was reduced to 55% by the removal of one positive outlier (Williams 1996), without affecting the overall significant result.”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2012) · cites this paper as Williams 1996
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Metadata
- Authors
- de Williams, C. A. C., Richardson, P. H., Nicholas, M. K., Pither, C. E., Harding, V. R., Ridout, K. L., Ralphs, J. A., Richardson, I. H., Justins, D. M., & Chamberlain, J. H.
- Affiliations
- Guy's Hospital (GB)
- Royal North Shore Hospital (AU)
- St Thomas' Hospital (GB)
- ORCID
- Nicholas, M. K.
- Venue
- Pain
- Published
- 1996-07
- Volume
- 66
- Issue
- 1
- Pages
- 13-22
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2035426342
- Cited by
- 199
- References
- 46
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 8 · 2020: 2 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 3 · 2015: 8 · 2014: 3 · 2013: 9 · 2012: 3
- FWCI
- 8.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- chronic pain, cognitive behavioral therapy, inpatient pain management, outpatient pain management, physical function, psychological functioning, analgesic use, health care utilization, maintenance of treatment effects
- MeSH terms
- Ambulatory Care, Female, Hospitalization, Humans, Male, Middle Aged, Palliative Care, Cognitive Behavioral Therapy
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