Impact evaluation of an interdisciplinary approach to patients with chronic non-cancer pain in Chilean primary care

Abstract

Introduction: Chronic non-cancer pain affects one-third of the global population. In Chile, its prevalence is estimated at 34%, surpassing the prevalence of diabetes mellitus and hypertension. Its high costs reveal that clinical treatment causes the greatest economic impact, followed by days of work absenteeism. Objective: This study aims to evaluate the impact on resource consumption, quality of life, and pain perception in patients with CNCP, an interdisciplinary approach implemented in Chilean primary care public health. Methods: A concurrent cohort study was conducted with patients aged 25 to 64 with chronic non-cancer musculoskeletal pain. The population studied was 698 patients receiving primary health services in centers with similar size and territorial proximity. The clinical intervention introduced patient-centered care, psychotherapy and physiotherapy from the perspective of the neuroscience of pain. The impact analysis was conducted using negative binomial regression models, generalized linear models, and ordered logistic regressions. Results: Results show that the patients who were intervened increased the number of physician consultations at primary care (IRR: 1.56; 95% CI 1.30–1.87) and increased medication consumption (coef 2.38; 95% CI 2.10–2.67) compared to control patients. Intervened patients improved their quality of life (COEF 0.14; 95% CI 0.09–0.19), and pain perception was statistically significant. Despite the health system’s structural, cultural, and organizational barriers, the intervention was implemented and consolidated in daily operation, providing learnings for a further scale-up. Conclusion: The study demonstrates that an interdisciplinary approach to chronic non-cancer pain management in Chilean primary care improves quality of life and pain perception while increasing healthcare resource use. Despite system barriers, the intervention was successfully implemented and sustained within patient-centered care. These findings highlight the need for resource reallocation to ensure long-term sustainability and scalability through the public health system.