Analysis of Referral Pathways, Diagnosis, and Treatment Patterns in a University -Based Orofacial Multidisciplinary Pain Clinic

• Author / Creator

  Badri, Parvaneh

• Background- The prevalence of multifactorial chronic diseases is increasing globally. The objective of this study was to examine associations between chronic orofacial pain complaints and psychological distress in patients assessed at a multidisciplinary clinic inspired by the biopsychosocial model.
  Methods- A retrospective study design was employed to analyse data collected from patient charts recorded at the University of Alberta Multidisciplinary Orofacial Pain Clinic between 2018-2023. The team comprises a pharmacist, dietitian, family physician, oral and maxillofacial surgeon, psychologist, orofacial pain and oral medicine specialist, along with the oral medicine residents. Demographic, clinical variables, psychological were retrieved. The psychological variables included the Adverse Childhood Experiences (ACE) scale, Pain Catastrophizing Scale (PCS), and Injustice Experience Questionnaire (IEQ). To evaluate the associations between the severity of TMJ pain and headaches and psychological variable scores, Pearson’s chi-square test, Fisher’s exact test, and binomial logistic regression were performed.
  Results- The study analysed 288 charts of patients ranging in age from 13 to 93 years (mean age 46.69, SD 16.5). Most patients were female (82.6%) and resided primarily in Alberta (94.4%), with some also from Saskatchewan and British Columbia. Self-reported behaviors included tobacco smoking (15.5%), alcohol consumption (59.4%), and recreational drug use (15.5% current, 8.5% past). This study confirmed significant associations in patients with a moderate or severe risk of PCS. Among these, patients had 3.7 and 3.9 times higher odds of experiencing moderate to severe TMJ pain and headaches, respectively, compared to those with a low PCS risk. Additionally, patients with a high risk of IEQ had 2.8 times higher odds of experiencing moderate to severe headaches compared to those with a low IEQ risk. About 14.8% of patients did not answer the ACE, PCS, or IEQ variables and were thus excluded from analysis.
  Conclusion- Pain severity in chronic orofacial symptoms (TMJ pain and headaches) was associated with higher PCS scores. Similarly, higher IEQ scores correlated with increased headache severity. The significant number of patients who declined to answer the psychological assessments suggests underlying psychological factors.

• Subjects / Keywords

  • Orofacial Multidisciplinary Pain Clinic

• Graduation date

  Fall 2024

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-v6vj-mq03

• License

  This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.