Clinical Outcomes of Multidisciplinary Pain Rehabilitation Among African American Compared with Caucasian Patients with Chronic Pain

摘要

Objectives. The primary aim of this study was to determine if the immediate outcomes of multidisciplinary pain rehabilitation were different for African Americans compared with Caucasians. Design. A retrospective repeated measures design was used, and all analyses were adjusted for marital and employment status, years of education, and pain duration. Setting. Multidisciplinary pain rehabilitation center. Subjects. Each African American (N=40) consecutively admitted to a multidisciplinary pain rehabilitation program was matched with three Caucasians (N=120) on age, sex, and treatment dates. Intervention. A 3-week outpatient multidisciplinary pain rehabilitation program. Outcome Measures. The Multidimensional Pain Inventory, Short Form-36 Health Status Questionnaire, Center for Epidemiologic Studies-Depression scale, and Pain Catastrophizing Scale were administered at admission and dismissal. Results. At baseline, African Americans had greater pain severity (P<0.001) and poorer physical function compared with Caucasians (P<0.001). At program completion, African Americans had greater pain severity (P<0.001) and poorer measures of life interference (P=0.004), perceived control (P= 0.013), affective distress (P<0.001), role physical (P=0.001) and role emotional function (P=0.001), physical (P<0.001) and social function (P=0.002), general health (P=0.005), depression (P<0.001), and pain catastrophizing (P<0.001). A repeated measures analysis demonstrated a time by race interaction effect for pain interference (P=0.038), affective distress (P=0.019), role physical function (P=0.007), social function (P=0.029), and depression (P=0.004), indicating African Americans experienced less improvement compared with Caucasians. Conclusions. The results of this study highlight an under-recognized health disparity which provides the basis for developing targeted interventions aimed at improving the clinical outcomes of African Americans with chronic pain.