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Controlled 3-year follow-up of a multidisciplinary pain rehabilitation program in primary health care
Örebro University, Department of Clinical Medicine. Psychosomat Med Clin, S-72214 Vasteras, Sweden; Psychosomat Med Clin, S-72214 Vasteras, Sweden. (Centre for Health and Medical Psychology (CHAMP), Örebro University)
Örebro University, School of Law, Psychology and Social Work. (Centre for Health and Medical Psychology (CHAMP), Örebro University)ORCID iD: 0000-0001-5359-0452
Uppsala Univ, Cent Hosp, Clin Res Ctr, Vasteras, Sweden.
Uppsala Univ, Cent Hosp, Clin Res Ctr, Vasteras, Sweden.
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2010 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 4, 307-316 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The high prevalence of musculoskeletal pain generates significant costs for primary health care and the whole of society. The development of appropriate interventions is therefore necessary. The aim of this effectiveness study was to assess the long-term effects of a primary health care multidisciplinary rehabilitation program in Sweden.

Methods: An experimental group comprising 89 patients from two primary health care units received individualised treatment interventions after a multidisciplinary investigation. A control group of 69 patients with the same inclusion criteria from four other primary health care units were treated according to routine. All participants completed questionnaires measuring pain, sick leave, quality of life, health care utilisation, drug consumption and psychosocial factors at baseline and at 3-year follow-up.

Results: After 3 years, utilisation of primary health care was significantly lower in the experimental group and work capacity was slightly but not significantly higher. The control group showed a trend of having a higher risk of high consumption after 3 years compared to the intervention group. There was no significant difference between the two groups concerning remaining variables such as function, catastrophising and pain.

Conclusion: Both groups demonstrated considerable improvement over the course of 3 years. The experimental group had lower health care utilisation and a reduced risk of using large amounts of medication at the 3-year follow-up, indicating that compared with participants in the control group they were coping in a better way with pain.

Place, publisher, year, edition, pages
Oxon, United Kingdom: Taylor & Francis, 2010. Vol. 32, no 4, 307-316 p.
Keyword [en]
Musculoskeletal pain, sick leave, multidisciplinary rehabilitation
National Category
Family Medicine
Research subject
Family Medicine; Rehabilitation Medicine
Identifiers
URN: urn:nbn:se:oru:diva-10061DOI: 10.3109/09638280903095924ISI: 000274263400006PubMedID: 20055569Scopus ID: 2-s2.0-75149145056OAI: oai:DiVA.org:oru-10061DiVA: diva2:304418
Available from: 2010-03-18 Created: 2010-03-18 Last updated: 2017-02-15Bibliographically approved
In thesis
1. Musculoskeletal pain in primary health care: a biopsychosocial perspective for assessment and  treatment
Open this publication in new window or tab >>Musculoskeletal pain in primary health care: a biopsychosocial perspective for assessment and  treatment
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Long-term musculoskeletal pain is a large public health problem with serious consequences for both the individual and society. Psychosocial factors have been shown to be good predictors of long-term disability and play an important role in the transition from acute to chronic pain. Early identification and intervention of those that run the risk of developing long-term disability would offer a great opportunity for reducing costs and personal suffering. The overall aim of this thesis was to assess a biopsychosocial approach to the assessment and management of musculoskeletal pain patients in primary health care.

To this end, biopsychosocial assessment and treatment methods were tested in two different populations of primary care patients suffering pain. Results indicated that improvements in quality of life and work capacity one year after early multimodal rehabilitation were basically maintained after five years. The most salient prognostic factors determining return to work were educational level and the individual’s perceived health (Study I). Psychosocial factors as measured by the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) were related to disability and perceived health three years after treatment for non-acute pain problems (Study II). The experimental group in the controlled multimodal pain rehabilitation programme had lower health care utilization and a reduced risk of using large amounts of medication after three years compared with the participants in the control group. However, there were no significant differences between the groups on variables such as work capacity, function, catastrophizing and pain (Study III). Distinct profiles of catastrophizing, fear-avoidance beliefs, and distress were extracted and meaningfully related to future sick leave and dysfunction (Study IV).

Our findings provide support for the biopsychosocial model and highlight the importance of psychosocial factors in long-term outcome. The results underscore the need for early identification of patients at risk. Further, multimodal treatment that covers not only biological but also psychosocial factors seems to be a key to successful treatment, and ideally this intervention should be matched to the patients' needs.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2010. 82 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 40
Keyword
musculoskeletal pain, biopsychosocial, multimodal, fear-avoidance, catastrophizing, distress, sick leave, function
National Category
Family Medicine Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Family Medicine; Rehabilitation Medicine
Identifiers
urn:nbn:se:oru:diva-10084 (URN)978-91-7668-716-1 (ISBN)
Public defence
2010-04-23, Aulan, ingång 21, 721 89, Centrallasarettet, Västerås, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-03-19 Created: 2010-03-18 Last updated: 2011-04-26Bibliographically approved

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