A Novel Examination of the Variables Associated with Treatment Completion to Interdisciplinary Treatments for Chronic Musculoskeletal Pain in Military Populations

Military personnel are at an increased risk of developing chronic musculoskeletal pain conditions and have deleteriously affected the United States economy and increased healthcare utilization. Interdisciplinary approaches for chronic pain are shown to be most effective. However, adherence to this type of treatment is less understood. This proposed study was an exploratory post-hoc secondary data analysis using data from two military-directed randomized control trials examining and establishing the efficacy of an interdisciplinary treatment for chronic musculoskeletal pain disorder in active duty service members and veterans. The study used parametric tests (e.g., regression model) and nonparametric tests (e.g., survival analysis models and a regression tree model) variables (i.e., depression, anxiety, posttraumatic stress disorder (PTSD), pain intensity, and disability) associated with treatment completion. No significant differences were observed in the overall influence of the predictors on treatment completion in the parametric tests, and assumptions of linearity were not met. The novel use of nonparametric testing indicated that PTSD had an effect on the timing of dropout. Also, the PTSD and pain intensity affected the rates of treatment completion when observing the clusters formulated by the decision tree. The information gathered from this study provides a a novel approach to measure treatment completion for interdisciplinary treatment in military personnel. Results from this study recommend future studies to incorporate and consider the following factors: implement parametric and nonparametric statistical strategies, implement pretreatment support to participate in interdisciplinary care, and investigate the timing and design sequence of treating PTSD and chronic pain in interdisciplinary treatment.