Long-term outcomes of multimodal rehabilitation in primary care for patients with chronic pain.

Abstract

To investigate the outcomes 1 year after multimodal rehabilitation programmes in primary care for patients with chronic pain, both as a whole and for men and women separately. A second aim was to identify predictive factors for not being on sickness absence at follow-up after 1 year. A prospective longitudinal cohort study of 234 patients, 34 men and 200 women, age range 18-65 years, who participated in multimodal rehabilitation programmes in primary care in 2 Swedish county councils. Pain, physical and emotional functioning, coping, health-related quality of life, work-related factors, sickness absence (sick leave, sickness compensation/disability pension) were evaluated prior to and 1 year after multimodal rehabilitation programmes. Patients showed significant improvements at 1-year follow-up for all measures (all p ≤ 0.004) except satisfaction with vocation (p = 0.060). The proportion of patients on sick leave decreased significantly at follow-up (p = 0.027), while there was no significant difference regarding the proportion of patients on sickness compensation/disability pension (p = 0.087). Higher self-rated work ability was associated with not being on sickness absence at 1-year follow-up (odds ratio (OR) 1.19, confidence interval (CI) 1.21-1.06, p = 0.005). This study indicates that multimodal rehabilitation programmes in primary care could be beneficial for patients with chronic pain, since the outcomes at 1-year follow-up for pain, physical and emotional functioning, coping, and health-related quality of life were positive. However, the effect sizes were small and thus further development of multimodal rehabilitation programmes is warranted in order to improve the outcomes.