What Is the Effectiveness of Different Duration Interdisciplinary Treatment Programs in Patients with Chronic Pain? A Large-Scale Longitudinal Register Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Intervention
2.4. Outcome (Dependent) Measures
2.4.1. Primary Outcome
2.4.2. Secondary Outcomes
2.5. Independent Variable and Statistics
3. Results
3.1. Results of Main Outcomes
3.1.1. Within-Group Analyses
3.1.2. Between-Group Analyses
3.2. Results of Secondary Outcomes
3.2.1. Within-Group Analyses
3.2.2. Between-Group Analyses
4. Discussion
4.1. Summary of Main Findings
4.2. Effectiveness of IMPR
4.3. Comparative Effectiveness
4.4. Methodological Discussion
4.5. Implications and Future Directions
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Short IMPR (n = 924) | Moderate IMPR (n = 1379) | Long IMPR (n = 395) | |
---|---|---|---|
Gender (%) females | 78.1 | 81.4 | 84.1 |
Age mean (SD) | 43.2 (10.5) | 39.7 (10.7) | 42.6 (10.0) |
Education level (%) | |||
Elementary | 13.7 | 12.0 | 12.2 |
Secondary | 56.7 | 56.8 | 53.7 |
University | 22.9 | 25.0 | 25.3 |
Other unspecified | 6.4 | 5.1 | 7.8 |
Country of origin (%) | |||
Sweden | 86.0 | 77.0 | 84.1 |
Other European country | 7.5 | 7.2 | 5.6 |
Outside Europe | 6.4 | 15.7 | 10.1 |
Pain duration (months) mean (SD) | 110.0 (102.5) | 93.7 (99.1) | 119.8 (108.1) |
Pain duration (months) median (IQR) | 73.0 (137.4) | 56.6 (122.9) | 87.0 (145.1) |
Number of pain regions mean (SD) | 16.0 (8.4) | 15.8 (8.6) | 16.1 (8.4) |
Working (%) | 51.5 | 59.5 | 53.5 |
Mean Within-Subject Change and Effect Size | |||||||||
---|---|---|---|---|---|---|---|---|---|
Baseline Mean (SD) | Post-IMPR Mean (SD) | 12-Month FU Mean (SD) | Baseline to PostIMPR * | 95% CI | ES | Baseline to 12 Month FU * | 95% CI | ES | |
SF-36 PCS (0–100) | 28.5 (7.8) | 30.8 (8.7) | 31.7 (9.6) | 2.0 | 1.7–2.3 | 0.28 | 2.8 | 2.4–3.2 | 0.37 |
SF-36 MCS (0–100) | 34.6 (12.7) | 39.1 (13.0) | 38.7 (13.3) | 4.3 | 3.8–4.9 | 0.35 | 3.8 | 3.1–4.4 | 0.32 |
Pain intensity last 7 days (NRS) (0–10) | 7.0 (1.6) | 6.1 (1.9) | 6.0 (2.1) | −0.8 | −0.9–−0.7 | −0.51 | −0.9 | 1.0–−0.8 | −0.54 |
EQ-5D index (−0.594–1) | 0.24 (0.30) | 0.36 (0.32) | 0.40 (0.34) | 0.11 | 0.10–0.12 | 0.39 | 0.14 | 0.12–0.15 | 0.50 |
HADS A (0–21) | 9.5 (4.8) | 8.0 (4.5) | 7.9 (4.8) | −1.4 | −1.6–−1.2 | −0.32 | −1.3 | −1.5–−1.1 | −0.33 |
HADS D (0–21) | 8.8 (4.4) | 6.6 (4.2) | 7.1 (4.6) | −2.2 | −2.3–−2.0 | −0.51 | −1.6 | −1.8–1.4 | −0.38 |
MPI Impairment (0–6) | 4.0 (0.8) | 3.4 (0.9) | 3.4 (1.1) | −0.5 | −0.6–−0.5 | −0.70 | −0.5 | −0.6–−0.5 | −0.62 |
MPI Social Support (0–6) | 3.5 (1.0) | 3.4 (1.0) | 3.4 (1.0) | −0.1 | −0.1–0.0 | 0.10 | −0.1 | −0.2–−0.1 | −0.10 |
Baseline | Post-IMPR | 12-Month Follow-Up | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Mean | 95% CI | Mean | 95% CI | p-Value | ES | Mean | 95% CI | p-Value | ES | |
SF-36 PCS (0–100) | ||||||||||
short | 27.9 | 27.4–28.4 | 30.2 | 29.7–30.8 | Ref. | 30.4 | 29.9–31.0 | Ref. | ||
medium | 28.6 | 28.2–29.1 | 31.6 | 31.1–32.2 | <0.01 | 0.17 | 32.1 | 31.6–32.6 | <0.01 | 0.26 |
long | 29.3 | 28.5–30.1 | 29.7 | 28.8–30.6 | 0.335 | −0.06 | 30.2 | 29.4–31.0 | 0.563 | −0.03 |
SF-36 MCS (0–100) | ||||||||||
short | 36.2 | 35.3–37.0 | 39.6 | 38.8–40.5 | 39.5 | 38.7–40.3 | ||||
medium | 33.8 | 33.1–34.5 | 38.6 | 37.9–39.4 | 0.084 | −0.08 | 38.5 | 37.8–39.2 | 0.055 | −0.11 |
long | 33.7 | 32.4–35.0 | 39.5 | 38.1–40.8 | 0.853 | −0.01 | 39.2 | 38.0–40.4 | 0.672 | −0.03 |
Pain intensity last 7 days (NRS) (0-10) | ||||||||||
short | 7.0 | 6.9–7.1 | 6.2 | 6.1–6.3 | 6.1 | 6.0–6.3 | ||||
medium | 7.0 | 6.9–7.1 | 6.1 | 5.96–6.2 | 0.166 | −0.07 | 6.0 | 5.9–6.1 | 0.100 | −0.08 |
long | 6.8 | 6.7–7.0 | 6.2 | 5.9–6.4 | 0.891 | −0.01 | 6.2 | 6.0–6.4 | 0.769 | 0.03 |
EQ-5D index (−0.594–1) | ||||||||||
short | 0.25 | 0.23–0.27 | 0.35 | 0.33–0.38 | 0.36 | 0.34–0.38 | ||||
medium | 0.22 | 0.20–0.23 | 0.37 | 0.35–0.39 | 0.313 | 0.05 | 0.39 | 0.37–0.41 | 0.052 | 0.11 |
long | 0.28 | 0.25–0.31 | 0.34 | 0.31–0.38 | 0.632 | −0.03 | 0.36 | 0.33–0.39 | 0.773 | −0.02 |
HADS A (0–21) | ||||||||||
short | 8.8 | 8.5–9.1 | 7.9 | 7.6–8.2 | 7.9 | 7.7–8.2 | ||||
medium | 9.9 | 9.6–10.1 | 8.0 | 7.8–8.3 | 0.528 | 0.03 | 8.0 | 7.7–8.2 | 0.824 | 0.01 |
long | 9.6 | 9.1–10.1 | 7.9 | 7.5–8.3 | 0.941 | −0.01 | 7.8 | 7.5–8.2 | 0.650 | −0.03 |
HADS A (0–21) | ||||||||||
short | 8.5 | 8.2–8.8 | 6.5 | 6.2–6.8 | 6.8 | 6.6–7.1 | ||||
medium | 9.0 | 8.8–9.2 | 6.6 | 6.4–6.8 | 0.519 | 0.03 | 6.7 | 6.5–6.9 | 0.555 | −0.03 |
long | 8.9 | 8.5- 9.3 | 6.7 | 6.4–7.1 | 0.293 | 0.07 | 7.0 | 6.6–7.4 | 0.425 | 0.06 |
MPI Impairment (0–6) | ||||||||||
short | 3.9 | 3.9–4.0 | 3.4 | 3.4–3.5 | 3.4 | 3.4–3.5 | ||||
medium | 4.1 | 4.0–4.1 | 3.4 | 3.4–3.5 | 0.547 | 0.02 | 3.4 | 3.3–3.5 | 0.240 | −0.05 |
long | 3.9 | 3.8–4.0 | 3.5 | 3.4–3.6 | 0.298 | 0.07 | 3.5 | 3.3–3.6 | 0.731 | 0.03 |
MPI Social Support (0–6) | ||||||||||
short | 3.5 | 3.5–3.6 | 3.5 | 3.4–3.5 | 3.5 | 3.4–3.5 | ||||
medium | 3.5 | 3.5–3.6 | 3.4 | 3.3–3.4 | 0.006 | −0.11 | 3.4 | 3.3–3.4 | 0.003 | −0.15 |
long | 3.4 | 3.3–3.5 | 3.5 | 3.4–3.6 | 0.388 | 0.06 | 3.5 | 3.4–3.6 | 0.879 | 0.02 |
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Tseli, E.; LoMartire, R.; Vixner, L.; Grooten, W.J.A.; Gerdle, B.; Äng, B.O. What Is the Effectiveness of Different Duration Interdisciplinary Treatment Programs in Patients with Chronic Pain? A Large-Scale Longitudinal Register Study. J. Clin. Med. 2020, 9, 2788. https://doi.org/10.3390/jcm9092788
Tseli E, LoMartire R, Vixner L, Grooten WJA, Gerdle B, Äng BO. What Is the Effectiveness of Different Duration Interdisciplinary Treatment Programs in Patients with Chronic Pain? A Large-Scale Longitudinal Register Study. Journal of Clinical Medicine. 2020; 9(9):2788. https://doi.org/10.3390/jcm9092788
Chicago/Turabian StyleTseli, Elena, Riccardo LoMartire, Linda Vixner, Wilhelmus Johannes Andreas Grooten, Björn Gerdle, and Björn O. Äng. 2020. "What Is the Effectiveness of Different Duration Interdisciplinary Treatment Programs in Patients with Chronic Pain? A Large-Scale Longitudinal Register Study" Journal of Clinical Medicine 9, no. 9: 2788. https://doi.org/10.3390/jcm9092788