Patients’ recall of diagnostic and treatment information improves with use of the Pain Explanation and Treatment Diagram in an outpatient chronic pain clinic

BACKGROUND To maximize the benefit of therapies, patients must understand their condition, recall treatment suggestions and comply with treatments. The Pain Explanation and Treatment Diagram (PETD) is a one-page worksheet that identifies risk factors (health-related habits, sleep, exercise, ergonomics and psychosocial factors) involved in chronic pain. Clinician and patient complete the PETD together, and the clinician notes recommended treatments and lifestyle changes. OBJECTIVES To examine the effect of use of the PETD on patient recall of diagnostic and treatment information on the sheet. METHODS The present study was a cross-sectional analysis. Patients with chronic musculoskeletal pain seen by one physiatrist at an outpatient pain clinic in a university-affiliated hospital between 2009 and 2012 (all of whom received the PETD) were eligible. A structured telephone interview lasting approximately 1 h was used to determine recall of PETD diagnostic and treatment information. RESULTS Of the 84 eligible patients, 46 were contacted and 29 completed the telephone interview. Participants recalled an average of 12.2% (95% CI 7.8% to 17.4%) of items without prompting and 48.5% (95% CI 42.0% to 53.5%) when prompted. Participants who referred to the PETD at home (n=13) recalled significantly more items than those who did not (n=15) (17.6% [95% CI 11.1% to 23.9%] versus 5.2% [95% CI 3.0% to 14.5%], P=0.004); when prompted, the rates increased to 54.3% (95% CI 48.3% to 61.2%) and 41.2% (95% CI 34.7% to 50.7%), respectively (P=0.032). CONCLUSIONS The PETD is a promising, feasible and inexpensive tool that can improve patients' recall of diagnostic- and treatment-related information.