Cost Reporting and Outcomes

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Introduction 

This review quantifies the effectiveness of the Holistic Centered Treatment (HCT) protocol to treat those suffering with CRPS, chronic pain and co-existing / co-morbid conditions. It also evaluates the cost savings of an evidence based, non-invasive and drug free protocol aka HCT Intensives -vs- traditional treatments currently utilized for these demographics and diagnosis.

Holistic Centered Treatment's CRPS | Chronic Pain Intensive is a two-week outpatient program, approximately 5 hours per day, and it's followed by a 90-day home program.  Our Intensive is the equivalent of 3-4 months at other clinics.  

The Holistic Centered Treatment protocol is designed to assist patients in getting out of 'fight or flight' (sympathetic overload), breaking the pain loop, managing stress and anxiety, increasing restorative sleep, and giving them the tools and resources to have long-term outcomes.    

Our program takes a whole-body approach.  We are working with the biology and physiology of the body and putting in treatment modalities that assist with systemic neural adaption, balancing the autonomic nervous system, and returning the body to homeostasis while addressing PTSD.  

This is a multi-modality, evidence based, outcome based, non-invasive and drug free protocol that is individualized to meet patient's specific needs and goals.  We are addressing all aspects of chronic pain – physically, mentally, emotionally, and spiritually.  All while individualizing the treatment to meet each person's specific needs and goals.

We have a primary focus is on those living with complex regional pain syndrome (CRPS), fibromyalgia, phantom limb pain, central sensitization syndrome (CSS), amplified musculoskeletal pain syndrome (AMPS), neuropathic pain, small fiber neuropathy (SFN), failed surgical pain, etc.  We are also addressing co-existing conditions.

Our multi-modality protocol includes - Laser / LLLT, PEMF, neuroplasticity training, biofeedback, neurofeedback, microcurrent, clinical hypnosis, breathwork, EMDR, working with the vagus nerve, light/sound therapy, and peptides.  

It is this combination that is helping chronic pain patients gain functional levels and regain their lives.

At intake, all participants rate quality of life, pain, and sleep quality. 

Participants in the HCT Intensive program experience large, statistically significant, improvement in pain levels, stress, 

anxiety, depression, insomnia, hope, and quality of life.  

Participants are gaining functional levels and regaining their lives. 

At 30 days, 60 days, 90 days, 6 month and 1 year follow up, 

statistically significant improvement was maintained.

Following a HCT Intensive patients are returning to actively engaging with family, work, and social activities. 

The cost savings of the HCT Intensive vs traditional treatments are significant. The overall- cost savings tied into socioeconomics is immeasurable. We cannot put a price tag on quality of life, hope, and happiness. 

Analysis

CRPS and chronic pain has been linked to restricted mobility, opioid dependency, anxiety, depression, insomnia, and reduced quality of life, and it contributes to an estimated $635 billion annually in direct medical costs, lost productivity, and disability programs in the United States. 

The 2016 National Pain Strategy called for more precise prevalence estimates of chronic pain and high-impact chronic pain to reliably establish the burden of chronic pain and aid in the development and implementation of population-wide pain interventions. 

CRPS and chronic pain don’t discriminate. It affects all ages, demographics and those in all socioeconomic areas. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), neuropathic pain, psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).  A person may have two or more co-existing chronic pain conditions.  Such conditions can include chronic fatigue syndrome, dysautonomia, complex regional pain syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, and/or temporomandibular joint dysfunction. It is not known whether these disorders share a common cause. Left untreated or under-treated chronic pain leads to unemployment, significant economic impact, pediatric and adolescents out of school, and for many it leads to suicide. 

Overview

Holistic Centered Treatment created a two-week outpatient Intensive program. This has a specific focus on those living with various diagnoses of chronic pain (CRPS/RSD, fibromyalgia, phantom limb pain, neuropathic pain, SFN, EDS, etc.) and co-existing / co-morbid conditions.  This is referred to as a “HCT Intensive”. 

All participants in the HCT Intensives have 30-day, 60-day, 90-day, 6 month and 1 year follow up. Statistically significant improvement was maintained. 

The evaluation described here is a quantitative, non-experimental evaluation of the effectiveness of the HCT Intensive. We are looking at outcomes related to pain, quality of life, sleep, hope, reduction in anxiety and stress, and other symptoms of PTSD. We use self-reporting assessments given at pre-treatment, post-treatment and follow-up intervals. 

Statistical Analysis and Outcomes 

HCT Intensive Treatment of Chronic Pain (CRPS/RSD, Fibromyalgia, SFN, Phantom Limb Pain, Neuropathic Pain, etc.) 

For each assessment, paired responses were used to compare scores at pre-treatment to post-treatment, and at pre-treatment to 1-year follow-up. Specific diagnosis will be delineated separately. 

CRPS 

(Type 1 & Type 2) 

[N = 42] 

Pre-Treatment: 

• Pain Level: 9.1 (Rated on a scale of 0-10. 10 being the worst pain imaginable.) 
• Sleep Quality: 2.7 (Rated on a scale of 0-10. 10 being the best.) 
• Quality of Life: 2 (Rated on a scale of 0-10. 10 being the best.) 
• Hope: 1 (Rated on a scale of 0-10. 10 being the best.) 

Post-Treatment: 

(The average ending levels following Intensive with HCT) 

• Pain Level: 1.1 (Rated on a scale of 0-10. 10 being the worst pain imaginable.) 
• Sleep Quality: 7.7 (Rated on a scale of 0-10. 10 being the best.) 
• Quality of Life: 8.7 (Rated on a scale of 0-10. 10 being the best.) 
• Hope: 9.0 (Rated on a scale of 0-10. 10 being the best.) 

1-Year Post Treatment: 

[N=39] 

• Pain Level: 0.47 (Rated on a scale of 0-10. 10 being the worst pain imaginable.) 
• Sleep Quality: 8.1 (Rated on a scale of 0-10. 10 being the best.) 
• Quality of Life: 8.9 (Rated on a scale of 0-10. 10 being the best.) 
• Hope: 9.0 (Rated on a scale of 0-10. 10 being the best.) 

Fibromyalgia 

[N = 4] 

Pre-Treatment: 

• Pain Level: 8.7 (Rated on a scale of 0-10. 10 being the worst pain imaginable.) 
• Sleep Quality: 2.1 (Rated on a scale of 0-10. 10 being the best.) 
• Quality of Life: 2.7 (Rated on a scale of 0-10. 10 being the best.) 
• Hope: 2.1 (Rated on a scale of 0-10. 10 being the best.) 

Post-Treatment: 

(The average ending levels following Intensive with HCT) 

• Pain Level: 0.9 (Rated on a scale of 0-10. 10 being the worst pain imaginable.) 
• Sleep Quality: 8.1 (Rated on a scale of 0-10. 10 being the best.) 
• Quality of Life: 8.9 (Rated on a scale of 0-10. 10 being the best.) 
• Hope: 9.2 (Rated on a scale of 0-10. 10 being the best.) 

1-Year Post Treatment: 

[N=4] 

• Pain Level: 0.8 (Rated on a scale of 0-10. 10 being the worst pain imaginable.) 
• Sleep Quality: 8.6 (Rated on a scale of 0-10. 10 being the best.) 
• Quality of Life: 8.9 (Rated on a scale of 0-10. 10 being the best.) 
• Hope: 9.5 (Rated on a scale of 0-10. 10 being the best.) 

Conclusion

This shows the HCT Intensive is superior to traditional allopathic treatments for this demographic of patients. The majority of patients within these demographics are not getting better with traditional allopathic treatments. 

Based upon reports from health economists at Johns Hopkins University writing in The Journal of Pain, the annual cost of chronic pain is as high as $635 billion a year, which is more than the yearly combined costs for cancer, heart disease and diabetes.  

An outcome and evidence based, non-invasive and drug free protocol should be the first treatment considered when patients do not respond to initial traditional treatments.  Considering the current opioid epidemic that we are dealing with in the United States a drug-free protocol that focuses on treating the whole person must be considered.  

When patients feel there is no hope or help available to them – we seen suicide rates increasing. Yet, when we provide a treatment protocol that addresses all areas - physically, mentally, emotionally, and spiritually - then we are providing them with the hope and help they are seeking.  This is a critical step that will substantially drop suicide rates. 

Final Conclusion HCT Intensive Cost: 

HCT Intensive Cost: 

$15,000

Traditional Treatment Cost: 

Total W/O Spinal Cord Stimulator

$56,077.32/year

Total with Spinal Cord Stimulator

(No Complications)

$118,894.32

Total with Spinal Cord Stimulator

(With Complications)

$135,363.32 

*(Initial Year of SCS)

$77,467.32/year

**(Each subsequent year following

 initial SCS implant.)

The success rate of the above mentioned HCT Intensive is 85%. This allows patients can return to family, work, school, and/or other aspects of their lives. This dramatically decrease the socioeconomic impact and increase overall wellbeing (physically, emotionally, mentally and spiritually) too.   

Our outcomes show the HCT Intensive is superior to traditional allopathic treatments for this demographic of patients. 

Although program evaluation in the above-mentioned Intensive is limited by the lack of a control group, the Intensives appear to be a powerful intervention for chronic pain patients, those diagnosed with co-existing / co-morbid conditions. 

References https://www.jmcp.org/doi/pdf/10.18553/jmcp.2014.20.9.921 https://health.costhelper.com/pain-doctor.html https://health.costhelper.com/spinal-cord-stimulator.html https://health.costhelper.com/physical-therapist.html