Residential vs non-residential pain management: a systematic review of patient outcomes
Gillian WattersBackground
Intensive residential pain management programmes are often assumed to deliver superior outcomes for patients with complex chronic pain, yet recent evidence does not confirm this.
Aims
This systematic review compared outcomes from residential and non-residential intensive pain management programmes.
Methods
Database searches were undertaken in Medline, CINAHL and PBS. Eligible studies included adults with low back pain, published after April 2009, describing multimodal programmes of at least 100 hours. Outcomes were required in disability, pain intensity, quality of life or occupational function. Six studies met inclusion criteria, conducted across the Netherlands, UK, Denmark, France, Finland and the US.
Findings
All studies reported post-intervention improvements, irrespective of programme setting. No study demonstrated superior outcomes for residential programmes compared with non-residential alternatives.
Conclusions
For advanced clinical practitioners, programme intensity and structure may be more influential than setting.
Implications for practice
In practice, these findings support the adaptation of intensive multimodal programmes across different healthcare settings, with patient-centred assessment, appropriate triage, and context-specific service design central to effective implementation.