Swedish quality registry for pain rehabilitation: Purpose, Design, implementation and characteristics of referred patients

Abstract

Objective: In order to facilitate comparisons of pain rehabilitation programmes in Sweden and to enable audit spirals for single programmes as well as outcome studies, the Swedish Association for Rehabilitation Medicine initiated a national quality registry in 1995. Patients: Referred for rehabilitation due to pain-related disability. Methods: The registry collects standardized self-reports before assessment, after rehabilitation and one year later, covering demographic, educational and psychometric data, pain intensity, physical disability and life satisfaction. Sick leave data are collected from the National Insurance Board before and up to two years after rehabilitation. At each programme unit self-reports are processed into individual assessment profiles relevant to plan rehabilitation. Data are sent annually to the central registry for analysis and compared with "return to work" data. Each unit can compare its results with national means. Results and conclusion: The organization of the registry is described. Data indicating that contextual factors, but not pain characteristics, depression or activity limitations vary between patients referred to different centres, makes comparisons difficult. As of 2007, data from the multidisciplinary assessment of 19,833 patients have been collected. A total of 7289 patients attended a rehabilitation programme, generating two more self-reports. A limitation of the study is a lack of follow-up data from some units.

Low-Educated Women with Chronic Pain Were Less Often Selected to Multidisciplinary Rehabilitation Programs

“…In addition the team assessment was performed by experienced professionals with high staff continuity during the data collection period. Further, SQRP is a national register for pain rehabilitation and includes approximately 80% of pain management programs in Sweden [17]. The procedure used by the multidisciplinary team for selection of patients for multidisciplinary rehabilitation is similar throughout Sweden; thus, we can assume that the generalisability of the study is good on a national level.…”

“…Our outcome measure takes account of both diagnostic (International Classification of Diseases, 10th version (ICD-10)) and functional (International Classification of Disability, Impairment and Handicap (ICIDH)) components [17]. The SQRP consists of validated scales [20], [21].…”

“…Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation National Pain Register (SQRP) [17] and linked to the patients' individual records containing the final decision on being selected or not to multidisciplinary rehabilitation programs. The SQRP register has aggregated data since 1998 of all patients referred to the majority of Swedish rehabilitation units.…”

“…The SQRP register has aggregated data since 1998 of all patients referred to the majority of Swedish rehabilitation units. The SQRP is based on patients' information from validated self-administered questionnaires completed before the first multidisciplinary assessment [17]. The patients completed the set of questionnaires at home the night before the assessment and the questions refer to pain experiences during the day before the assessment.…”

Development and Implementation of a Registry of Patients Attending Multidisciplinary Pain Treatment Clinics: The Quebec Pain Registry

“…Patient registries can also be designed to (1) describe the progression of diseases, (2) monitor quality of care, (3) assess the cost-effectiveness of treatments, or (4) conduct outcome research studies [1–3]. Although they also have their limitations [1, 2, 4], patient registries represent interesting and alternative research avenues and are becoming more and more popular in subspecialities of pain medicine including management of acute postoperative pain (e.g., [9]), rheumatic diseases [10, 11], low back pain (e.g., [12]), and neuropathic pain (e.g., [13, 14]) as well as pain rehabilitation (e.g., [15]) and military-specific pain services (e.g., [16] to name just a few.…”