Multidimensional health changes after a multimodal pain rehabilitation program: a registry-based study

Grimby-Ekman, Anna; Kim, Malin; Stankovic, Nenad; Mannheimer, Clas

doi:10.1097/pr9.0000000000000938

Cited by 4 publications

(8 citation statements)

References 20 publications

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“…Both groups showed an overall tendency for improvement in the PROMs, namely, self-reported anxiety, depression and EQ5D, especially at the one-year follow-up, although some changes did not reach statistical significance. The effect of IPRP on these PROMs is in line with previous studies evaluating the effect of IPRP [ 10 , 45 ]. The patients who received the DAP intervention showed significant improvements in sleep, both at the post-rehabilitation follow-up and at the one-year follow-up.…”

Section: Discussionsupporting

confidence: 89%

“…The complexity of the disorder also raises the question of which parameters one can expect to be affected by a rehabilitation programme. A recent study found that pain intensity was one of the factors with the least probability of improvement, whilst depression was the factor with the highest probability of improvement in patients after participating in an IPRP in Sweden [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Including a Three-Party Meeting Using the Demand and Ability Protocol in an Interdisciplinary Pain Rehabilitation Programme for a Successful Return to Work Process

Aili

Hellman

Svartengren

et al. 2022

IJERPH

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The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Including a Three-Party Meeting Using the Demand and Ability Protocol in an Interdisciplinary Pain Rehabilitation Programme for a Successful Return to Work Process

Aili

Hellman

Svartengren

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, there are no studies on predictive factors in accordance with the ones presented here regarding a patient population with chronic, severe pain who has completed a similar one-to-one, physiotherapist-led rehabilitation program. Various patient-populations with various severeness of symptoms have been studied, various content of rehabilitation programs have been used, and the studies have been performed in various health care settings in specialized and in primary care [20,23,[40][41][42][43][44][45][46][47][48][49][50][51]. Moreover, the previous literature shows somewhat conficting results of that; no strong predictive baseline variables exist to predict successful outcome [20-23, 42, 46, 47], and worse baseline status can be associated with improved outcome after rehabilitation [23,40,42,[46][47][48], but also that poor pretreatment physical and psychological functioning at the baseline can have a negative prognosis [20].…”

Section: Discussionmentioning

confidence: 99%

“…Various patient-populations with various severeness of symptoms have been studied, various content of rehabilitation programs have been used, and the studies have been performed in various health care settings in specialized and in primary care [20,23,[40][41][42][43][44][45][46][47][48][49][50][51]. Moreover, the previous literature shows somewhat conficting results of that; no strong predictive baseline variables exist to predict successful outcome [20-23, 42, 46, 47], and worse baseline status can be associated with improved outcome after rehabilitation [23,40,42,[46][47][48], but also that poor pretreatment physical and psychological functioning at the baseline can have a negative prognosis [20]. Also, in previous studies, various outcomes and predictive baseline variables are used [20,23,[40][41][42][43][44][45][46][47][48][49][50][51].…”

Section: Discussionmentioning

confidence: 99%

Can Baseline Characteristics Predict Successful Outcomes after Individual, Physiotherapist-Led Rehabilitation in Patients with Chronic Musculoskeletal Pain?

Bondesson

Jöud

Fischer

et al. 2023

Pain Research and Management

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Background. No strong and consistent variables to predict outcome after pain rehabilitation have been reported in patients with chronic musculoskeletal pain. The aim of the present study was to clarify if baseline variables could predict successful outcome after a unique, individualized, physiotherapist-led rehabilitation of nine sessions. Methods. In 274 individuals with severe chronic musculoskeletal pain, the risk ratio (RR) and 95% confidence intervals (CIs) were estimated for potentially predictive baseline variables on successful outcomes of pain management, overall health, and pain rating. Results. Statistically significant results show that patients rating moderate or severe baseline pain were in both cases 14% less likely to improve pain management compared to patients rating mild baseline pain (RR = 0.86; 95% CI 0.77–0.97, RR = 0.86; 95% CI 0.74–1.00). Patients with the shortest pain duration were 1.61 times more likely to improve overall health (RR = 1.61; 95% CI 1.13–2.29) compared to patients reporting the longest pain duration (>5 years). Patients reporting anxiety/depression or severe pain were in both cases 1.48 times more likely to improve overall health compared to better baseline presentations (RR = 1.48; 95% CI 1.16–1.88, RR = 1.48; 95% CI 1.03–2.15). Patients with regional/generalized pain were 36% less likely to rate pain reduction (RR = 0.64; 95% CI 0.41–1.00) compared to patients rating localized baseline pain. Of 17 potentially predictive baseline variables, four reached statistical significance for at least one of the three outcomes; although none of them for all three outcomes. Conclusions. Of 17 potentially predictive baseline variables, mild pain ratings, short pain duration, and localized baseline pain were statistically significantly associated with improvements after individual, physiotherapist-led rehabilitation for patients with chronic musculoskeletal pain. This suggests that this type of rehabilitation probably should be offered early in the pain process. Reporting anxiety/depression or severe pain at the baseline did not hinder the improvements of overall health.

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“…For fibromyalgia, OMERACT 2 and others have suggested preliminary responder criteria based on several variables [38][39][40]. A similar approach that defines a total improvement variable based on the dichotomizing six variables was used by Grimby-Ekman et al [41].…”

Section: How To Evaluate the Complex Iprp Interventionmentioning

confidence: 99%

Perspective Chapter: Interdisciplinary Pain Rehabilitation Programs – Evidence and Clinical Real-World Results

Gerdle¹,

Fischer²,

Ringqvist³

2024

Pharmaceutical Science

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Chronic pain conditions are influenced by and interact with physical, psychological, social, and contextual factors. These conditions are associated with psychological distress, poor health, sick leave, and high socio-economic costs. Therefore, modern clinical practice applies a biopsychosocial (BPS) framework. Interdisciplinary pain rehabilitation programs (IPRPs) for chronic pain distinguish themselves as well-coordinated complex interventions. This chapter describes the contents of such programs. We will briefly review the evidence for IPRPs and discuss problems when evaluating these complex interventions. Furthermore, we will report practice-based results from a large Swedish pain registry—the Swedish Quality Registry for Pain Rehabilitation (SQRP). The SQRP collects data from a relevant special clinical department in Sweden—i.e., real-life outcomes will be depicted. Characteristics of patients that benefit the most from IPRPs will be described and discussed. The indications for IPRPs will also be presented. Finally, we will discuss how to improve rehabilitation for chronic pain patients.

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Multidimensional health changes after a multimodal pain rehabilitation program: a registry-based study

Abstract: Supplemental Digital Content is Available in the Text. A third of patients improved simultaneously in several domains, and a third improved in few or none. Pain intensity was the least likely outcome to improve.

Cited by 4 publications

References 20 publications

Including a Three-Party Meeting Using the Demand and Ability Protocol in an Interdisciplinary Pain Rehabilitation Programme for a Successful Return to Work Process

Including a Three-Party Meeting Using the Demand and Ability Protocol in an Interdisciplinary Pain Rehabilitation Programme for a Successful Return to Work Process

Can Baseline Characteristics Predict Successful Outcomes after Individual, Physiotherapist-Led Rehabilitation in Patients with Chronic Musculoskeletal Pain?

Perspective Chapter: Interdisciplinary Pain Rehabilitation Programs – Evidence and Clinical Real-World Results

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