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Featured researches published by U. Kaiser.


Schmerz | 2014

Multimodale Schmerztherapie für die Behandlung chronischer Schmerzsyndrome

B. Arnold; T. Brinkschmidt; H.-R. Casser; A. Diezemann; I. Gralow; Dominik Irnich; U. Kaiser; B. Klasen; K. Klimczyk; J. Lutz; B. Nagel; M. Pfingsten; Rainer Sabatowski; R. Schesser; M. Schiltenwolf; D. Seeger; W. Söllner

Multimodal pain management is a comprehensive treatment of complex chronic pain syndromes. In addition to medical therapy various other specialized therapeutic interventions based on the biopsychosocial model of pain origin and chronic pain development, are added. During the last few years treatment centers for chronic pain have been established throughout Germany. Multimodal pain management has been included in the official catalogue of the recognized medical procedures for day clinic units as well as for inpatient pain management. In daily practice there is, however, still a lack of clarity and of consistency about the components that multimodal pain management should contain. This is the reason for the ad hoc commission on multimodal interdisciplinary pain management of the German Pain Society to propose the following position paper that has been worked out in a multilevel and interdisciplinary consensus process. The paper describes the mandatory treatment measures in the four core disciplines of multimodal pain management, pain medicine, psychotherapy, exercise therapy including physiotherapy and assistant medical professions including nurses.ZusammenfassungMultimodale Schmerztherapie (MMST) ist eine umfassende Behandlung komplexer Schmerzsyndrome unter Einbindung verschiedener medizinischer Disziplinen und Berufsgruppen auf der Basis eines biopsychosozialen Modells der Schmerzentwicklung. In Deutschland sind in den letzten Jahren verschiedene Einrichtungen etabliert worden, die MMST anbieten. Die MMST wurde für das tagesklinische und das stationäre Behandlungssetting in den Prozedurenkatalog medizinischer Leistungen (OPS) aufgenommen. Dabei besteht in der Versorgungspraxis oft Unklarheit, was MMST ist und welche Bestandteile ein solches Behandlungsprogramm haben soll.Aus diesem Grund hat die Ad-hoc-Kommission Multimodale Schmerztherapie der Deutschen Schmerzgesellschaft in einem mehrstufigen Konsensusprozess das vorliegende Positionspapier erarbeitet. Dabei werden die in der MMST regelhaft zur Anwendung kommenden Behandlungsmaßnahmen in den vier Kernbereichen der MMST – Medizin/Algesiologie, Psychotherapie, Physio-/Bewegungstherapie und Pflege/medizinische Assistenzberufe – dargestellt.AbstractMultimodal pain management is a comprehensive treatment of complex chronic pain syndromes. In addition to medical therapy various other specialized therapeutic interventions based on the biopsychosocial model of pain origin and chronic pain development, are added. During the last few years treatment centers for chronic pain have been established throughout Germany. Multimodal pain management has been included in the official catalogue of the recognized medical procedures for day clinic units as well as for inpatient pain management.In daily practice there is, however, still a lack of clarity and of consistency about the components that multimodal pain management should contain. This is the reason for the ad hoc commission on multimodal interdisciplinary pain management of the German Pain Society to propose the following position paper that has been worked out in a multilevel and interdisciplinary consensus process. The paper describes the mandatory treatment measures in the four core disciplines of multimodal pain management, pain medicine, psychotherapy, exercise therapy including physiotherapy and assistant medical professions including nurses.


Schmerz | 2009

Evaluation einer multimodalen Schmerztherapie am UniversitätsSchmerzCentrum Dresden

A. Schütze; U. Kaiser; U. Ettrich; K. Große; G. Goßrau; M. Schiller; K. Pöhlmann; K. Brannasch; R. Scharnagel; Rainer Sabatowski

BACKGROUND Data of a multimodal pain management program of the multidisciplinary pain management centre at the University Hospital of Dresden is presented. Over a period of 4 weeks, supplemented by an additional week 3 months later (booster week), patients with chronic pain of different origins are being treated in groups of 12. Based on the principles of the biopsychosocial pain model and the idea of functional restoration, the program is dedicated for pain patients where outpatient treatment was insufficient. METHODS The program was evaluated on the basis of pain intensity (NRS), pain disability (PDI), fear and depression (HADS-D), catastrophizing (CSQ) and health-related quality of life and vitality (SF-36). The data were collected at the beginning and end of the initial 4 week treatment period, at the end of the booster period as well as 6 and 12 months after the end of active treatment. RESULTS A total of 189 patients were included in the program in the period from January 2006 until August 2008. All outcome parameter showed statistically significant improvements with small to high effect sizes (ES 0.20-0.95). The results stayed stable even 1 year after the treatment. The highest effect sizes were found in catastrophizing (ES 0.86) and average pain intensity (ES 0.95). The primary pain diagnosis (e. g. low back pain versus headache) had no impact on treatment outcome. CONCLUSION Significant and clinically relevant improvements could be achieved with the multimodal pain management program in groups of 12 patients. The results were stable over a time period of 1 year. Pain diagnosis had no impact on the outcome.


European Journal of Pain | 2016

A systematic review of the outcomes reported in multimodal pain therapy for chronic pain

Stefanie Deckert; U. Kaiser; Christian Kopkow; Freya Trautmann; Rainer Sabatowski; Jochen Schmitt

There are no recommendations provided for the outcome domains of chronic pain that should be explicitly considered in each clinical trial to describe the efficacy and effectiveness of multimodal pain therapy (MPT). Our aims were to summarize all reported outcome domains in studies assessing the effects of MPT for chronic pain, and to subsequently inform a consensus‐based development of a core outcome set of domains in this field.


Trials | 2015

Core outcome set to assess effectiveness in multimodal pain therapy – preliminary results of an interdisciplinary online survey

Christian Kopkow; Stefanie Deckert; Jochen Schmitt; Rainer Sabatowski; U. Kaiser

Background For multimodal pain therapy (MPT), a bio-psycho-social therapy approach for patients suffering from chronic pain, a core outcome set (COS) is currently lacking. Following the recommendations from initiatives such as Outcome Measures in Rheumatology (OMERACT) and Harmonizing Outcome Measures for Eczema (HOME), the study “Validation and Application of a patient relevant core set of outcome domains to assess multimodal PAIN therapy” (VAPAIN) aims to develop an accepted and valid COS for MPT.


BMJ Open | 2015

Validation and application of a core set of patient-relevant outcome domains to assess the effectiveness of multimodal pain therapy (VAPAIN): a study protocol

U. Kaiser; Christian Kopkow; Stefanie Deckert; Rainer Sabatowski; Jochen Schmitt

Introduction Multimodal pain therapy (MPT) has been established accounting for biopsychosocial consideration in diagnostic and therapy. MPT seems to be effective, but comparability of studies is limited due to diversity of study designs and outcome measurements. The presented study aims to develop a core outcome set consisting of a minimum of outcome measures deemed necessary for medical and therapeutic decision-making, which must be measured in all clinical trials and non-randomised intervention studies. Methods and analysis The study consists of several parts. First, the development and recommendation of preliminary core outcome domains will be based on results of a systematic review and structured online surveys. Participants of the expert panel are representatives of methodological, medical, physiotherapeutic, psychotherapeutic profession and patients suffering from chronic pain (n=25). Subsequently, candidate instruments to measure preliminary core outcome domains will be recommended by these experts. Therefore, systematic reviews on measurement properties of preliminary outcome measures will be conducted and finalised in a consensus meeting. Consented instruments and lacking psychometric properties of relevant instruments will be addressed and validated in the following part, a prospective multicentre study in multimodal pain centres on approximately 300 patients with chronic pain. Based on all previous results, a core outcome set for MPT measured in effectiveness studies and daily recordkeeping will be finalised by consensus. Statistical analyses will be performed according to methodological standards (COSMIN). Ethics and dissemination The methods and procedure of the study are developed in compliance with the ethical principles of the Helsinki Declaration and Good Epidemiologic Practice. Recruitment of study participants will require approval of the study by the responsible ethics committee and signed informed consent from each participant. Pseudonymised data will be used for statistical analysis.


Journal of Pain Research | 2013

Multidisciplinary pain management programs

U. Kaiser; B. Arnold; M. Pfingsten; B. Nagel; Johannes Lutz; Rainer Sabatowski

Ulrike Kaiser1 Bernhard Arnold2 Michael Pfingsten3 Bernd Nagel4 Johannes Lutz5 Rainer Sabatowski1,6 1Comprehensive Pain Center, University Hospital “Carl Gustav Carus”, Dresden, 2Department of Pain Management, Klinikum Dachau, Dachau, 3Pain Clinic, University Medicine, University of Gottingen, 4Day Care Unit, DRK Pain Center, Mainz, 5Interdisciplinary Pain Center, Zentralklinik Bad Berka, Bad Berka, 6Department of Anesthesiology and Intensive Care, University Hospital “Carl Gustav Carus”, Dresden, Germany


The Journal of Rheumatology | 2015

Is Chronic Pain a Disease in Its Own Right? Discussions from a Pre-OMERACT 2014 Workshop on Chronic Pain

Ann Margaret Taylor; Kristine Phillips; Justin O. Taylor; Jasvinder A. Singh; Philip G. Conaghan; Ernest Choy; Peter Tugwell; U. Kaiser; V. Strand; Lee S. Simon; Philip J. Mease

At the pain workshop held prior to the Outcome Measures in Rheumatology (OMERACT) 12 conference, chronic nonmalignant pain (CP) as a “disease” was discussed, in response to growing interest in this concept and in terms of the effect on the OMERACT Filter 2.0 framework. CP is often assessed as a unidimensional outcome measure; however, if CP is a disease, then outcome measures need to define the disease state and identify all its manifestations as well as its effects, as specified by Filter 2.0. The aim was to write a discussion piece, reflecting the workshop contributions and debate, as an important step in opening a dialogue around future OMERACT Filter 2.0 Framework developments.


Schmerz | 2014

Multimodal pain therapy for treatment of chronic pain syndrome. Consensus paper of the ad hoc commission on multimodal interdisciplinary pain management of the German Pain Society on treatment contents

B. Arnold; T. Brinkschmidt; H.-R. Casser; A. Diezemann; I. Gralow; Dominik Irnich; U. Kaiser; B. Klasen; K. Klimczyk; J. Lutz; B. Nagel; M. Pfingsten; Rainer Sabatowski; R. Schesser; Marcus Schiltenwolf; D. Seeger; W. Söllner

Multimodal pain management is a comprehensive treatment of complex chronic pain syndromes. In addition to medical therapy various other specialized therapeutic interventions based on the biopsychosocial model of pain origin and chronic pain development, are added. During the last few years treatment centers for chronic pain have been established throughout Germany. Multimodal pain management has been included in the official catalogue of the recognized medical procedures for day clinic units as well as for inpatient pain management. In daily practice there is, however, still a lack of clarity and of consistency about the components that multimodal pain management should contain. This is the reason for the ad hoc commission on multimodal interdisciplinary pain management of the German Pain Society to propose the following position paper that has been worked out in a multilevel and interdisciplinary consensus process. The paper describes the mandatory treatment measures in the four core disciplines of multimodal pain management, pain medicine, psychotherapy, exercise therapy including physiotherapy and assistant medical professions including nurses.ZusammenfassungMultimodale Schmerztherapie (MMST) ist eine umfassende Behandlung komplexer Schmerzsyndrome unter Einbindung verschiedener medizinischer Disziplinen und Berufsgruppen auf der Basis eines biopsychosozialen Modells der Schmerzentwicklung. In Deutschland sind in den letzten Jahren verschiedene Einrichtungen etabliert worden, die MMST anbieten. Die MMST wurde für das tagesklinische und das stationäre Behandlungssetting in den Prozedurenkatalog medizinischer Leistungen (OPS) aufgenommen. Dabei besteht in der Versorgungspraxis oft Unklarheit, was MMST ist und welche Bestandteile ein solches Behandlungsprogramm haben soll.Aus diesem Grund hat die Ad-hoc-Kommission Multimodale Schmerztherapie der Deutschen Schmerzgesellschaft in einem mehrstufigen Konsensusprozess das vorliegende Positionspapier erarbeitet. Dabei werden die in der MMST regelhaft zur Anwendung kommenden Behandlungsmaßnahmen in den vier Kernbereichen der MMST – Medizin/Algesiologie, Psychotherapie, Physio-/Bewegungstherapie und Pflege/medizinische Assistenzberufe – dargestellt.AbstractMultimodal pain management is a comprehensive treatment of complex chronic pain syndromes. In addition to medical therapy various other specialized therapeutic interventions based on the biopsychosocial model of pain origin and chronic pain development, are added. During the last few years treatment centers for chronic pain have been established throughout Germany. Multimodal pain management has been included in the official catalogue of the recognized medical procedures for day clinic units as well as for inpatient pain management.In daily practice there is, however, still a lack of clarity and of consistency about the components that multimodal pain management should contain. This is the reason for the ad hoc commission on multimodal interdisciplinary pain management of the German Pain Society to propose the following position paper that has been worked out in a multilevel and interdisciplinary consensus process. The paper describes the mandatory treatment measures in the four core disciplines of multimodal pain management, pain medicine, psychotherapy, exercise therapy including physiotherapy and assistant medical professions including nurses.


Pain | 2014

Dose or content? Effectiveness of pain rehabilitation programs for patients with chronic low back pain: A systematic review. Waterschoot et al., Pain 155 (2014) 179-189.

U. Kaiser; Stefanie Deckert; Christian Kopkow; Jochen Schmitt; Rainer Sabatowski

of studies with heterogeneous groups of treatments, patient populations, follow-up times, outcomes and measurements per outcome. In the absence of standardized outcome measurements, we categorized the measurements related to disability, work participation, and quality of life. However, in this systematic review, we reported data and outcomes of a heterogeneous source of studies in the literature. Factors such as patient compliance and motivation are known to affect outcome [2,3]. However, data regarding these factors are rarely reported in randomized controlled trials (RCTs) in general, and were not reported in our source literature; therefore, we could not report on these and other relevant issues. As we described, in the Discussion section of our review, it is difficult to disentangle dose and content aspects of PRPs; but, from our point of view, it is very important to include all aspects of a study in order to analyze the effects of PRPs. We agree with Williams [5] that our review has laid some groundwork for further research to disentangle dose and content factors in PRPs so as to improve these programs. Finally, we disagree with Beckmann and Schiltenwolf that discussing dose of treatment appears to be premature. Our review has demonstrated that dose issues have been neglected in PRP research, and we believe that studying dose in PRPs is necessary and long overdue.


Schmerz | 2013

Chronische nichttumorbedingte Schmerzen

R. Scharnagel; U. Kaiser; A. Schütze; R. Heineck; Gossrau G; Rainer Sabatowski

Annually published data show a continual increase in the volume of opioid prescriptions in Germany, thus indicating an intensification of opioid therapy. The majority of opioids are prescribed to treat chronic non-cancer-related pain. On the basis of current guidelines, as well as in terms of the lack of data regarding long-term use of opioids and their effectiveness beyond a period of 3 months, this development must be viewed critically. With reference to four case reports, we discuss and evaluate opioid therapy in relation to medication misuse and the development of drug dependency. Particular emphasis is placed on the administration of rapid-release and short-acting opioid preparations, which we consider to be particularly problematic.

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Rainer Sabatowski

Dresden University of Technology

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Jochen Schmitt

Dresden University of Technology

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M. Pfingsten

University of Göttingen

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Stefanie Deckert

Dresden University of Technology

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A. Schütze

Dresden University of Technology

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Christian Kopkow

Dresden University of Technology

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R. Scharnagel

Dresden University of Technology

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Friedrich Balck

Dresden University of Technology

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Katrin Neustadt

Dresden University of Technology

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