Neurological Institute Outcomes

Cleveland Clinic's Chronic Pain Neuro-Rehabilitation Program (CPNP) is an intensive outpatient program (IOP) that focuses primarily on physical reconditioning, medication management, social reengagement, and psychological coping strategies to ensure that chronic pain and other complex neurological symptoms do not take over a person's life. The goal of this program is to restore maximum level of comfort and function among those with persistent pain conditions. This program is offered in a predominantly virtual format wherein patients participate in group behavioral sessions 4 hours per day, 4 days per week, as well as virtual medication management appointments. This program also includes a 1 week intensive physical and occupational therapy program, which is delivered in person.

Among patients who completed the IOP, there were statistically and clinically meaningful improvements in all patient reported outcomes except for anxiety (GAD-7) (for which sample size was much smaller due to lower completion rates). Among patients who did not complete the IOP, there was statistically significant improvement in PROMIS Fatigue, PROMIS Pain Interference, and PROMIS Social Satisfaction, likely attributed to other treatment effects that were not controlled for in this analysis. Importantly, when comparing whether unadjusted change in score was different between the 2 groups, the group that completed the IOP had significantly more improvement for the majority of the pain outcomes measures (PROMIS Global Health Physical, PROMIS Global Health Mental, PROMIS Pain Interference, PROMIS Physical Function, PCS Total Score and subscores, and depression (PHQ-9 total score)).