Abstract
BackgroundThere is a large and unexplained practice variation in prescribed dosages of pain rehabilitation programs (PRP), and evidence regarding the optimum dosage is unknown.MethodsTo explore perspectives of patients and rehabilitation professionals regarding dosages of PRP an explorative qualitative research design was performed with thematic analysis. Patients and rehabilitation professionals were recruited from three rehabilitaton centers in the Netherlands. A purposive sample of patients who completed a PRP, with a range of personal and clinical characteristics was included. Rehabilitation professionals from all different disciplines, working within multidisciplinary PRP for a minimum of two years, for at least 0.5 fte were included. Individual semi-structured interviews were conducted with 12 patients undergoing PRP, and three focus groups were formed with a total of 17 rehabilitation professionals involved in PRP.ResultsAll patients were satisfied with received dosage. Factors important in relation to dosage of PRP were categorized into patient related characteristics (case complexity from a biopsychosocial perspective) to treatment related characteristics (logistics and format of the program, interaction between patients and professionals), and external factors (support from others, costs, traveling distance and injury compensation). Professionals concluded that dosage was currently based on historical grounds and clinical expertise.ConclusionPatients and professionals from different centers considered the same factors related to dosage of PRP, but these considerations (from patients and professionals) led to different dose choices between centers. PRP dosage appeared to be mainly based on historical grounds and clinical expertise. The insights of this study could assist in future research regarding optimum dosage of PRP and rehabilitation programs in general.
Highlights
There is a large and unexplained practice variation in prescribed dosages of pain rehabilitation programs (PRP), and evidence regarding the optimum dosage is unknown
This study aimed at exploring perspectives of patients and rehabilitation professionals to acquire insight into factors that may contribute to dose choices of multidisciplinary outpatient PRP
Seventeen rehabilitation professionals participated in the focus groups (Adelante in Hoensbroek: n = 5, Roessingh in Enschede: n = 5, Center for Rehabilitation of the University Medical Center of Groningen (UMCG) in Groningen: n = 7)
Summary
There is a large and unexplained practice variation in prescribed dosages of pain rehabilitation programs (PRP), and evidence regarding the optimum dosage is unknown. Multidisciplinary Pain Rehabilitation Programs (PRPs) are recommended to treat patients with chronic musculoskeletal pain (CMP) [1, 2]. These PRPs, based on the biopsychosocial model, aim to decrease disability and optimize participation of patients with CMP. A systematic review showed that PRPs have a moderate, but consistent, positive effect on disability and pain, compared to usual care. The multidisciplinary characteristics, as well as the high number of contact hours and total duration of PRP, provide relatively high direct costs and travel expenses for the patients.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
