Clinical- and cost-effectiveness of the STAR care pathway compared to usual care for patients with chronic pain after total knee replacement: study protocol for a UK randomised controlled trial.

Approximately 20% of patients experience chronic pain after total knee replacement. There is little evidence for effective interventions for the management of this pain, and current healthcare provision is patchy and inconsistent. Given the complexity of this condition, multimodal and individualised interventions matched to pain characteristics are needed. We have undertaken a comprehensive programme of work to develop a care pathway for patients with chronic pain after total knee replacement. This protocol describes the design of a randomised controlled trial to evaluate the clinical- and cost-effectiveness of a complex intervention care pathway compared with usual care.This article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site

Life satisfaction in patients with chronic musculoskeletal pain and its predictors

<p>Purpose To determine the life satisfaction of patients with chronic non-malignant musculoskeletal pain (CMP) compared to the general population (GP) and to identify predictors of life satisfaction.</p><p>Methods Subjects were patients with CMP (n = 1,082) admitted to multidisciplinary rehabilitation and a general population sample (n = 506). Lisat-9 measures satisfaction with life as a whole and eight life domains. Physical, emotional and social functioning and pain intensity were assessed using the SF-36. Ordinal logistic regression was used to analyse differences between patients with CMP and the GP, and predictors of life satisfaction in patients with CMP.</p><p>Results Compared to the general population, patients with CMP reported lower satisfaction with 'life as a whole', and with six life domains: self-care, leisure, vocational and financial situation, sex life and contacts with friends. In the CMP group, pain was associated with satisfaction with self-care, vocational situation, partnership, family life and contacts with friends. Marital status, age and mental health were associated with most satisfaction scores.</p><p>Conclusions Compared to the general population, patients with CMP reported lower satisfaction with 'life as a whole' and most life domains. The most consistent predictors of life satisfaction were marital status, mental health, vitality and pain.</p>