Discussion : While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR , poor pretreatment physical and psychological functioning influenced the prognosis negatively .
Thus , treatment should further target and optimize these modifiable factors and an increased focus on positive , psychological protective factors may perhaps provide an opening for yet untapped clinical gains
Objectives : This systematic review aim ed to identify and evaluate prognostic factors for long-term ( ≥6 mo ) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation ( MDR ) .
Predictors of outcome of multidisciplinary treatment in chronic widespread pain: an observational study
Background The effectiveness of multidisciplinary treatment in chronic widespread pain ( CWP ) is limited . The considerable heterogeneity among patients is a likely explanation . Knowledge on predictors of the outcome of multidisciplinary treatment can help to optimize treatment effectiveness . The purpose of this study was to identify predictors of multidisciplinary treatment outcome in patients with CWP . Methods Data were used from baseline and 6 months follow-up measurements of a prospect i ve cohort study of 120 CWP . Regression models were used to assess whether baseline variables predicted treatment outcome . Outcome domains included : pain , pain interference , depression , and global perceived effect ( GPE ) . Potential predictors included : psychological distress , illness and self-efficacy beliefs , fear-avoidance beliefs and behaviour , symptoms , disability , and socio-demographic factors . Results Greater improvement in pain was predicted by more pain at baseline and male gender . Greater improvement in interference of pain in daily life was predicted by more interference of pain in daily life at baseline , lower levels of anxiety , a stronger belief in personal control , less belief in consequences , male gender , and a higher level of education . Greater improvement in depression was predicted by higher baseline values of depression , stronger beliefs in personal control , and a higher level of education . Better outcome on GPE was predicted by less pain , less fatigue , and a higher level of education . Conclusion Less anxiety , stronger beliefs in personal control , less belief in consequences , less pain , less fatigue , higher level of education , and male gender are predictors of better outcome of multidisciplinary treatment in CWP . Tailoring treatment to these specific patient characteristics or selecting eligible patients for multidisciplinary treatment may further improve treatment outcome
Discussion : While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR , poor pretreatment physical and psychological functioning influenced the prognosis negatively .
Thus , treatment should further target and optimize these modifiable factors and an increased focus on positive , psychological protective factors may perhaps provide an opening for yet untapped clinical gains
Objectives : This systematic review aim ed to identify and evaluate prognostic factors for long-term ( ≥6 mo ) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation ( MDR ) .