Multidisciplinary pain education program (MPEP) for chronic pain patients: preliminary evidence for effectiveness and mechanisms of change

Objective: There is a need for effective brief interventions in chronic pain patients, and the identification of mechanisms of change. Method: In the present study, we tested the effectiveness of MPEP (Multidisciplinary Pain Education Program), a very brief, four-session cognitive-behaviorally based psycho-educational intervention for chronic pain using a pre- and post-test design. In addition, pre- to post-treatment change scores were calculated to investigate factors associated with change in pain. Participants of the study were 53 patients with chronic non-cancer pain. Primary outcome measures were (1) pain severity, (2) health perception, and (3) severity of depression. Secondary outcome measures included factors that have been implicated in the maintenance of chronic pain and that might be associated with worse treatment outcome: (1) catastrophizing, (2) kinesiophobia, and (3) action-proneness. Results: Findings provided preliminary evidence for the effectiveness of MPEP in that patients showed significant and clinically meaningful improvements in pain symptoms (F = 24.503, p<0.001, d = 0.59) and action-proneness (F = 178.504, p<0.001, d = 1.95), and small improvements in health perception (F = 7.116, p<0.05, d = 0.30). Furthermore, results showed that changes in catastrophizing (beta = -0.455, p = 0.001) and severity of depression (beta = -0.300, p<0.05) were independently and significantly associated with changes in pain. However, changes in health perception, kinesiophobia, and action-proneness were not significantly associated with changes in pain (beta = 0.203, ns; beta = 0.003, ns; and beta = 0.154, ns, respectively). Importantly, duration of chronic pain was not related to treatment outcome (beta = 0.070, ns). Conclusions: Overall, this study provides preliminary evidence for the effectiveness of MPEP and possible mechanisms through which MPEP is effective. Yet, further research is needed to investigate the efficacy of MPEP.