■描述慢性肌肉骨骼疼痛(CMP)患者的跨学科多模式疼痛治疗(IMPT)直至治疗后12个月的结果。
■数据是在3年期间(2019-2021年)在六个荷兰康复中心的常规临床实践中收集的。评估包括患者报告的多个领域的结果指标,包括残疾,疼痛和疲劳。使用重复测量模型并通过量化应答率分析纵向数据。
■包括2309名平均年龄为43.7(SD12.9)岁的患者,其中73%为女性。所有结果在每个时间点都显示出显著的改善。出院时,发现残疾的效应大小很大,平均和最严重的疼痛,疲劳和健康相关的生活质量。改善在12个月内基本持续。相对较大比例的患者在治疗后具有临床相关的改善(疼痛相关的残疾:60%;平均疼痛:52%;最严重的疼痛:37.4%;工作能力:50%;浓度:50%;疲劳:46%)。接受延长治疗的患者显示出所有结果指标的进一步改善,除了平均疼痛。
■在组级别,所有结局均显著改善,主要效应大小较大.结果大多是持续的。显示临床相关改善的患者比例往往大于先前报道的混合CMP患者。
慢性肌肉骨骼疼痛可能非常致残,影响参与和生活质量。通常,一些社会心理因素有助于维持疼痛及其不断变化的后果。在这项研究中,一个61小时的高度个性化的跨学科多模式疼痛治疗导致显着改善与中等到非常大的效应大小的所有重要领域,如疼痛,疲劳,残疾,工作能力,和生活质量。护理提供者和健康保险公司应承认跨学科多模式疼痛计划是其临床决策中的有效治疗方法。
UNASSIGNED: To describe the outcomes of an interdisciplinary multimodal pain treatment (IMPT) for chronic musculoskeletal pain (CMP) patients up until 12 months post-treatment.
UNASSIGNED: Data were gathered during routine clinical practice during a 3-year period (2019-2021) at six Dutch rehabilitation centres. Assessments included patient-reported outcome measures for multiple domains including disability, pain and fatigue. Longitudinal data were analysed using repeated-measures models and by quantifying responder rates.
UNASSIGNED: Included were 2309 patients with a mean age of 43.7 (SD 12.9) years, of which 73% female. All outcomes showed significant improvements at each timepoint. At discharge, large effect sizes were found for disability, average and worst pain, fatigue and health-related quality of life. Improvements were largely sustained at 12-months. Relatively large proportions of patients had clinically relevant improvements after treatment (pain-related disability: 60%; average pain: 52%; worst pain: 37.4%; work capacity: 50%; concentration: 50%; fatigue: 46%). Patients who received a treatment extension showed further improvements for all outcome measures, except average pain.
UNASSIGNED: At group level, all outcomes significantly improved with mainly large effect sizes. The results were mostly sustained. The proportion of patients showing clinically relevant improvements tends to be larger than previously reported for mixed CMP patients.
Chronic musculoskeletal pain can be very disabling and impacting participation and quality of life.Often several psychosocial factors contribute to the maintenance of pain and its evolving consequences.In this
study, a 61 hours highly individualized interdisciplinary multimodal pain treatment resulted in significant improvements with moderate to very large effect sizes for all important domains like pain, fatigue, disability, work capacity, and quality of life.Care providers as well as health insurers should acknowledge the interdisciplinary multimodal pain programme as an effective treatment in their clinical decision making.