Effects of Interdisciplinary Treatment on Sickness Absence in Patients With Chronic Pain
Condition: Chronic Pain
MeSH terms: Chronic Pain
Study type: Observational

Summary: 
      Chronic pain is a globally prevalent condition that causes enormous social costs; largely due
      to sickness absence. A common intervention for patients with chronic pain problems is
      interdisciplinary treatment (IDT), which consists of a combination of physical exercise,
      cognitive behavioural therapy and work training coordinated in an interdisciplinary team.
      Based on data from Swedish National Registers, this study evaluates the effects of IDT on
      sickness absence.
    

Detailed description: 
      This is a completely register-based observational cohort study. The study population is
      defined from the Swedish Quality Registry for Pain Rehabilitation (SQRP), which routinely
      aggregates data from specialist IDT pain management clinics across Sweden. SQRP contains
      information on the exposure/intervention: whether a patient that visited a SQRP-affiliated
      clinic was allocated to an IDT program (test) or not (control); t0 defined as the day of the
      IDT assessment. Microdata from SQRP is linked to other Swedish registers via the unique
      personal identification number held by all Swedish residents. Outcome data is obtained from
      the Swedish Social Insurance Agency. Registers managed by the National Board of Health and
      Welfare include data on dispensed prescription pharmaceuticals and specialist health care.

      Markov multistate survival-based methods will be used to compare the sickness absence between
      groups. Specifically, length of stay per sickness absence state (no sickness absence, sick
      leave, and disability pension) will be compared over five years from t0. Both crude and
      adjusted estimates will be presented. Adjustment will be made based on our hypothesis about
      causal relationships and include: history of sickness absence, sociodemographics (age, sex,
      sociodemographic status), patient disability (emotional distress, everyday interference, and
      confidence in future improvement), and governmental policy (IDT assessment year and
      geographical region of IDT clinic).
    

Intervention name(s): interdisciplinary treatment
Intervention type(s): Behavioral
Intervention description(s): Interdisciplinary treatment (IDT) distinguishes itself as an interdisciplinary-coordinated (e.g., physician, occupational therapist, physiotherapist, and psychologist) intervention using a bio-psycho-social view of chronic pain. The MMR continues over a lengthy period with a common goal and generally includes patient education, supervised physical activity, simulated work training, and cognitive behavioural therapy (CBT). The exact composition of these MMR components depends on initial evaluations of the patients health status and furhter follow-up testing. The MMR interventional components can act independently and interdependently, resulting in combined effects due to known and unknown mechanisms; the effects are intended to be greater than the sum of its components.
Other intervention name(s): multimodal rehabilitation
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients that visited a Swedish SQRP-affiliated IDT specialist clinic.