Individually reported effectiveness of therapy for chronic pain.

In 1996, a primary care-based multidisciplinary group model for treating patients with chronic pain was begun in a large HMO. Prior to the visits, patients completed an assessment, which included their description of previous and current therapies and their effectiveness (inventory developed by A. G. Lipman). This article describes the reports of the first 163 patients. Females were referred three times more often than males; the average age was 52 (range 18 to 88); average years in pain = 11 (range 0.3-50). Most patients reported more than one source of pain. No therapy was reported to be effective for everyone; what was highly effective for one could actually increase pain in another. Side effects caused patients to discontinue even effective therapy. Costly does not mean more effective. It is, therefore, essential that a systematic process of accessment, evaluation, and titration be employed with every intervention.