Present status and prospect of psychotherapy in Japan

Efficacy of interdisciplinary treatment for chronic nonmalignant pain patients in Japan

OBJECTIVES

The implementation of interdisciplinary pain management is a relatively new concept in Japan. Although there are more than 4200 pain specialists in Japan at present, no multidisciplinary pain center has yet to be established. This prospective study is, to our knowledge, the first published evaluation of the effectiveness of multidisciplinary/interdisciplinary pain treatment in Japanese patients with chronic noncancer pain.

METHODS

Ninety-nine patients with chronic noncancer pain were treated by an interdisciplinary approach in a Japanese outpatient pain clinic. Treatment was on the basis of the biopsychosocial model of pain and consisted of the following components: (1) education; (2) exercise and stretch; (3) long-term and short-term goal setting; (4) medication management; and (5) cognitive and behavioral techniques for problem solving and changing maladaptive behaviors. Each treatment session was 30 minutes and was held once every 1 to 3 weeks for 8 to 12 times according to the patients' progress and availability. The patients were assessed before and 2 to 4 weeks after the treatment.

RESULTS

Results showed (1) 68.9% of patients reported a significant decrease in pain, (2) 92.0% stopped using inappropriate medication including nonsteroidal anti-inflammation drugs, benzodiazepines and muscle relaxants, (3) 51.4% underwent their usual daily activities without being disturbed by pain, and (4) 75.0% who had been unemployed because of pain returned to work. Overall, the treatment succeeded in 56.8% of the patients.

CONCLUSIONS

Our results suggest that an interdisciplinary treatment based upon the biopsychosocial model of pain was associated with significant improvement in multiple outcomes in this sample of Japanese patients with chronic pain.