1. 2021;24;E1299-E1306Feasibility and Clinical Utility of Assessing Behavioral and Psychological Risk Factors in Pain Management
   Pilot Study
   Alexis M. Rojas, MS, Phillip R. Worts, PhD, and Gilbert S. Chandler III, MD.

BACKGROUND: The role of psychological factors influencing chronic pain is well documented, although less is known about the implication and logistics of conducting behavioral and psychological assessments in clinical practice, specifically within pain management.

OBJECTIVES: To identify the feasibility and clinical utility of assessing behavioral and psychological risk factors in pain management, as well as documenting the challenges and opportunities of integrating multidisciplinary care into a pain management practice.

STUDY DESIGN: A convenience sample of pain management patients was prospectively recruited from a private, multispecialty orthopedic clinic in Tallahassee, Florida. All patients reported experiencing chronic pain (i.e., greater than 3 months).

METHODS: Patients were approached before their initial clinical interaction at the pain management clinic. Approximately one year following their initial appointment, medical records were reviewed to determine the patients’ responses to treatment and subsequent management of their ailments.

RESULTS: Findings from the pilot study suggest that the behavioral and psychological assessments identified much higher rates of depression and suicidal ideations and lower resilience within the sample than in previously published US rates. The median time to complete the consent and battery was 30.2 minutes [interquartile range: 21]. This suggests that a shortened battery appears feasible in a pain management practice and could offer benefit by identifying factors that are known to impact clinical care.

LIMITATIONS: This study is limited in sample size, restricting generalizability. The incomplete follow-up survey data and cross-sectional nature of the study are also limitations.

CONCLUSIONS: The utility and feasibility of psychological and behavioral health assessments appear to be a critical component of a pain management practice as there is substantial overlap with psychological comorbidities (e.g., depression and anxiety) and chronic pain. Positive affect, such as resilience, may act to confer some protection against the sequelae of chronic pain, and identifying such factors appears vital.

KEY WORDS: Chronic pain, biopsychosocial, multidisciplinary, integrated behavioral health, resiliency