Predictors of multidisciplinary treatment outcome in patients with chronic musculoskeletal pain.

Abstract

PURPOSE:

The present study aimed to identify predictors of rehabilitation outcome for patients with chronic musculoskeletal pain (CMP) and psychological problems.

METHODS:

A retrospective cohort study including 230 adult patients with CMP admitted for multidisciplinary pain rehabilitation. Potential predictors were patient characteristics, duration of complaints, baseline functioning, pain, personality, coping style, fear of movement, psychological distress and type of treatment. Outcome measures were physical functioning, mental health, pain and patient-reported effect. Multiple (logistic) regression models were used to identify predictors.

RESULTS:

Patients who were more disabled and patients with more pain benefitted more from the rehabilitation treatment than less disabled patients or those with less pain. Age, work status, vitality, depression and coping style also predicted outcomes significantly. The models explained between 27 and 80% of the outcomes. There was an interaction between type of treatment, work status and the baseline pain score as regards the outcome in terms of pain.

CONCLUSIONS:

No strong predictors of treatment outcome were found other than the baseline scores of the respective outcome variables. More disabled patients and patients with more pain benefitted more from the rehabilitation program. Other predictors improved the prediction models slightly. Implications for Rehabilitation It remains challenging to correctly predict the outcome of treatment from patients' baseline sociodemographic and psychological characteristics; predictors other than baseline scores of the outcome variables are only slightly associated with treatment outcome. Patients with chronic musculoskeletal pain and poor physical functioning or mental health benefit most from pain rehabilitation. Older patients benefit less from a pain rehabilitation program than younger patients in terms of physical functioning. Pain reduction during a pain rehabilitation program is greatest in patients with high pain intensity who are not at work at the start of the rehabilitation program. Coping style influences the outcome of rehabilitation of patients with chronic musculoskeletal pain.

• Authors: Anne M Boonstra, Michiel F Reneman, Berend R Waaksma, Henrica R Schiphorst Preuper, Roy E Stewart
• Journal: Disability and rehabilitation (Disabil Rehabil) Vol. 37 Issue 14 Pg. 1242-50 ( 2015) ISSN: 1464-5165 [Electronic] England
• PMID: 25228388 (Publication Type: Journal Article)

Topics

• Adaptation, Psychological
• Adolescent
• Adult
• Aged
• Chronic Pain (psychology, rehabilitation)
• Disabled Persons (rehabilitation)
• Female
• Humans
• Logistic Models
• Male
• Mental Health
• Middle Aged
• Musculoskeletal Pain (psychology, rehabilitation)
• Pain Management
• Prognosis
• Retrospective Studies
• Treatment Outcome
• Young Adult