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Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres
BACKGROUND: For patients with chronic pain, the heterogeneity of clinical presentations makes it difficult to identify patients who would benefit from multimodal rehabilitation programs (MMRP). Yet, there is limited knowledge regarding the predictors of MMRP’s outcomes. This study identifies predict...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5124266/ https://www.ncbi.nlm.nih.gov/pubmed/27887616 http://dx.doi.org/10.1186/s12891-016-1346-7 |
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author | Gerdle, Björn Molander, Peter Stenberg, Gunilla Stålnacke, Britt-Marie Enthoven, Paul |
author_facet | Gerdle, Björn Molander, Peter Stenberg, Gunilla Stålnacke, Britt-Marie Enthoven, Paul |
author_sort | Gerdle, Björn |
collection | PubMed |
description | BACKGROUND: For patients with chronic pain, the heterogeneity of clinical presentations makes it difficult to identify patients who would benefit from multimodal rehabilitation programs (MMRP). Yet, there is limited knowledge regarding the predictors of MMRP’s outcomes. This study identifies predictors of outcome of MMRPs at a 12-month follow-up (FU-12) based on data from the Swedish Quality Registry for Pain Rehabilitation (SQRP). METHODS: Patients with chronic pain from two clinical departments in Sweden completed the SQRP questionnaires—background, pain characteristics, psychological symptoms, function, activity/participation, health and quality of life—on three occasions: 1) during their first visit; 2) immediately after the completion of their MMRP; and 3) 12 months after completing the MMRP (n = 227). During the FU-12, the patients also retrospectively reported their global impressions of any changes in their perception of pain and their ability to handle their life situation in general. RESULTS: Significant improvements were found for pain, psychological symptoms, activity/participation, health, and quality of life aspects with low/medium strong effects. A general pattern was observed from the analyses of the changes from baseline to FU-12; the largest improvements in outcomes were significantly associated with poor situations according to their respective baseline scores. Although significant regressors of the investigated outcomes were found, the significant predictors were weak and explained a minor part of the variation in outcomes (15–25%). At the FU-12, 53.6% of the patients reported that their pain had decreased and 80.1% reported that their life situation in general had improved. These improvements were associated with high education, low pain intensity, high health level, and work importance (only pain perception). The explained variations were low (9–11%). CONCLUSIONS: Representing patients in real-world clinical settings, this study confirmed systematic reviews that outcomes of MMRP are associated with broad positive effects. A mix of background and baseline variables influenced the outcomes investigated, but the explained variations in outcomes were low. There is still a need to develop standardized and relatively simple outcomes that can be used to evaluate MMRP in trials, in clinical evaluations at group level, and for individual patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-016-1346-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5124266 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-51242662016-12-08 Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres Gerdle, Björn Molander, Peter Stenberg, Gunilla Stålnacke, Britt-Marie Enthoven, Paul BMC Musculoskelet Disord Research Article BACKGROUND: For patients with chronic pain, the heterogeneity of clinical presentations makes it difficult to identify patients who would benefit from multimodal rehabilitation programs (MMRP). Yet, there is limited knowledge regarding the predictors of MMRP’s outcomes. This study identifies predictors of outcome of MMRPs at a 12-month follow-up (FU-12) based on data from the Swedish Quality Registry for Pain Rehabilitation (SQRP). METHODS: Patients with chronic pain from two clinical departments in Sweden completed the SQRP questionnaires—background, pain characteristics, psychological symptoms, function, activity/participation, health and quality of life—on three occasions: 1) during their first visit; 2) immediately after the completion of their MMRP; and 3) 12 months after completing the MMRP (n = 227). During the FU-12, the patients also retrospectively reported their global impressions of any changes in their perception of pain and their ability to handle their life situation in general. RESULTS: Significant improvements were found for pain, psychological symptoms, activity/participation, health, and quality of life aspects with low/medium strong effects. A general pattern was observed from the analyses of the changes from baseline to FU-12; the largest improvements in outcomes were significantly associated with poor situations according to their respective baseline scores. Although significant regressors of the investigated outcomes were found, the significant predictors were weak and explained a minor part of the variation in outcomes (15–25%). At the FU-12, 53.6% of the patients reported that their pain had decreased and 80.1% reported that their life situation in general had improved. These improvements were associated with high education, low pain intensity, high health level, and work importance (only pain perception). The explained variations were low (9–11%). CONCLUSIONS: Representing patients in real-world clinical settings, this study confirmed systematic reviews that outcomes of MMRP are associated with broad positive effects. A mix of background and baseline variables influenced the outcomes investigated, but the explained variations in outcomes were low. There is still a need to develop standardized and relatively simple outcomes that can be used to evaluate MMRP in trials, in clinical evaluations at group level, and for individual patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-016-1346-7) contains supplementary material, which is available to authorized users. BioMed Central 2016-11-25 /pmc/articles/PMC5124266/ /pubmed/27887616 http://dx.doi.org/10.1186/s12891-016-1346-7 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Gerdle, Björn Molander, Peter Stenberg, Gunilla Stålnacke, Britt-Marie Enthoven, Paul Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres |
title | Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres |
title_full | Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres |
title_fullStr | Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres |
title_full_unstemmed | Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres |
title_short | Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two SQRP centres |
title_sort | weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain—a practice based evidence study from two sqrp centres |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5124266/ https://www.ncbi.nlm.nih.gov/pubmed/27887616 http://dx.doi.org/10.1186/s12891-016-1346-7 |
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