(556) Chronic pain rehabilitation and alcohol use disorder: promising outcomes in an interdisciplinary treatment program

s The Journal of Pain S115 (556) Chronic pain rehabilitation and alcohol use disorder: promising outcomes in an interdisciplinary treatment program F Kenner, E Shella, B Tilahun, E Covington, M Mathews, and J Scheman; Cleveland Clinic Chronic Pain Rehabilitation Program, Cleveland, OH There is a significant literature on treating patients with co-morbid pain and addiction; however, most of these studies involve patients with addiction to medication used to treat their pain, including opioids and benzodiazepines. There is scant literature addressing chronic pain treatment outcomes of patients with alcohol use disorder. This study examined outcomes of 19 patients diagnosed with alcohol use disorder in the previous 30 days versus 19 ageand sex-matched controls following treatment in a comprehensive interdisciplinary 3-4 week chronic pain rehabilitation program at the Cleveland Clinic that includes a substance abuse education track for patients with any type of substance use disorder. Outcome variables included: pain, mood and function on admission and discharge following completion of the chronic pain rehabilitation program. Specific variables included pain intensity 0-10, scores on the DASS depression and anxiety scales; and the 7 items on the Pain Disability Index. Both groups had similar levels of pain, mood and impaired function, with the exception of higher admission anxiety scores for those with an alcohol use disorder (M = 17.5 vs. 8.2). There were no significant differences in outcomes between the two groups and no difference in discharge anxiety scores which normalized in both groups. Although this is a small number of patients, these findings suggest that patients with an active alcohol use disorder can benefit from treatment in a chronic pain rehabilitation program. Additional studies are underway to examine long term outcomes as well as sobriety rates. (557) Age and education matched comparison of female and male veterans participating in an inpatient chronic pain rehabilitation program S Rafie, K Phillips, and J Murphy; James A Haley Veterans’ Hospital, Tampa, FL Studies of Veterans Affairs (VA) patients show that pain is a significant problem among both male and female veterans. The number of female veterans is fast growing in the Veterans Health Administration (VHA), and is expected to continue rising. Current literature suggests there are differences between male and female veterans with regard to chronic pain treatment. To date, the efficacy of treatment for chronic non-cancer pain in female veterans is understudied. Furthermore, there is a paucity of studies that have compared females to an age and educationmatched comparison group ofmales. The purpose of the present study was to explore the differences between female and male veterans participating in an inpatient chronic pain rehabilitation program (CPRP). We conducted a retrospective survey of veterans (N=243) who completed the 3-week, interdisciplinary CPRP. Female (n=122) and male (n=121) veterans were matched within 2 years of age and 1 year of education. Participants were assessed at admission and discharge using self-report data. Females and males were compared on demographic (e.g., race), clinical (e.g., opioid analgesic use), and pain-outcome (e.g., pain level) variables using appropriate statistics (e.g., chi square or t-tests for baseline comparisons; repeated measures analyses of variance for change over time in pain-related outcomes between sexes). Datawill be presented on differences between sexes on demographic and clinical characteristics. Furthermore, results suggest that both male and female CPRP participants demonstrate improvements over time in pain-related outcomes, including pain level, pain-related negative affect, pain-related interference, and sleep (p-values<.01). Given the increase in the number of female veterans entering the VA system, these data are likely to address gaps in our current knowledge of female veterans’ experiences and needs in pain management, and have implications for better serving female veterans with chronic pain. (558) Child pain, function, and psychological outcomes in associationwith treatment duration in intensive interdisciplinary pediatric pain rehabilitation C Hoffart, R Anderson, A Chapman, B Dorton, D Feltrop, M Wilson, and D Wallace; Children’s Mercy Hospital, Kansas City, MO Weexamined the functional, psychological, and pain-related outcomes among children with chronic pain completing an intensive interdisciplinary pediatric pain rehabilitation program. We hypothesized that baseline psychological measures would predict a longer treatment course while baseline pain severity would not correlate with program duration. This outpatient program provides 5-6 hours of daily intensive physical therapy and occupational therapy in addition to yoga, self-regulation training, individual and group behavioral health intervention, group-based music and art therapy, and parent group intervention. All painmedications are discontinued, and no invasive therapeutic procedures are utilized. 22 patients (18 female) aged 11-18 with chronic musculoskeletal pain completed Functional Disability Inventory, 100mm Visual Analog Scale, PROMIS Anxiety, Depression, Pain Interference, and Mobility, PRCQ-catastrophizing, and the Pain AcceptanceQuestionnaire for Adolescents at baseline, the end of eachweek, and 19 have completed a one-month followup. Themean program duration was 3.6 (6 0.9) weeks, determined by achievement of functional goals. Using paired samples t-tests, current pain (VAS 0-100) significantly decreased from 61.7 to 31.0 (P=0.001) at post-treatment followup. FDI improved from 27.6 to 13.9 between baseline and program end (P<.0001), and continues to improve following treatment (P=0.002). Patient reported anxiety and depression decline significantly (P=0.004 and P=0.001, respectively), while pain acceptance increases significantly during treatment (P<.001). Patients report less catastrophizing following treatment (P=.001). Treatment program duration correlated with baseline pain interference (r=.470; P=.027), functional disability (FDI r=.664; P=.001), and presence of conversion symptoms (r=.548; P=.008). Patients with greater mobility (PROMIS; r =-.671; P =.001) and pain acceptance (CPAQ-A; r = -.537; P=.018) at baseline required shorter treatment intervention. Children with chronic musculoskeletal pain successfully restore function and improve pain without pharmacotherapy. Baseline functional disability and psychological factors correlate with treatment program duration. Prospective studies are warranted to determine long-term efficacy and effectiveness of this interdisciplinary program. (559) Rehabilitative therapy for the treatment of chronic abdominal pain in children W Bernal, J Tress, P Weiss, and D Sherry; The Children’s Hospital of Philadelphia, Philadelphia, PA Multidisciplinary rehabilitative therapy is effective in treating amplified musculoskeletal pain in pediatric patients, but its efficacy in the treatment of chronic abdominal pain is not known. Our center treats pediatric patients with amplified pain using physical & occupational therapy, psychotherapy, and art m 0-12 no to minimal , 13-29 moderate, 30-60 severe). 53 subjects fulfilled inclusion criteria, 43 (81%) of which had abdominal pain as part of chronic diffuse pain. 62%were female and 88%werewhite. At baseline evaluation, the mean verbal pain and FDI scores were 5.8 (95%CI: 5.0,6.7) and 26.7 (95% CI: 22.8,30.7), respectively. There were no significant differences in pain or FDI scores between patients with localized abdominal pain and those with diffuse pain. Of the initial 53 subjects, 40 (75%) were admitted to our rehabilitation program. Admitted subjects had higher mean pain (6.5 vs. 4.2, p < 0.05) and FDI (29.2 vs. 21, p < 0.05) scores. Most subjects (95%, N=38/40) completed the rehabilitation program. Mean length of stay was 25.2 days (95% CI: 21.2, 29.2). Completion of the program resulted in a mean change in the verbal pain and FDI scores of –3.9 (95% CI: -5.2,-2.7; p < 0.001) and– 19.5 (95% CI: -25.5,-13.6; p < 0.001), respectively, at 1 month after discharge. In pediatric patients disabled by amplified pain of the abdomen, multidisciplinary rehabilitative therapy restores function and decreases pain, and, importantly, this improvement was sustained after program discharge.