TY - JOUR
T1 - Longitudinal outcome evaluations of Interdisciplinary Multimodal Pain Treatment programmes for patients with chronic primary musculoskeletal pain
T2 - A systematic review and meta-analysis
AU - Elbers, S.
AU - Wittink, H.
AU - Konings, S.
AU - Kaiser, U.
AU - Kleijnen, J.
AU - Pool, J.
AU - Koke, A.
AU - Smeets, R.
N1 - Funding Information:
This research was funded by a SIA RAAK grant (2014‐01‐23P) and by a personal PhD grant from the University of Applied Sciences Utrecht.
Funding Information:
This research was funded by a SIA RAAK grant (2014-01-23P) and by a personal PhD grant from the University of Applied Sciences Utrecht. We greatly appreciate the help that we received from Myrthe Konijnenburg with the data extraction and the expertise of Dr Marc Teunis, Julien Groenenboom, Mees Fröberg, and Britte Heijink for during the development and deployment of the online multimedia appendix.
Publisher Copyright:
© 2021 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®
PY - 2022/2
Y1 - 2022/2
N2 - Background and objectives Although Interdisciplinary Multimodal Pain Treatment (IMPT) programmes share a biopsychosocial approach to increase the wellbeing of patients with chronic pain, substantial variation in content and duration have been reported. In addition, it is unclear to what extent any favourable health outcomes are maintained over time. Therefore, our first aim was to identify and analyse the change over time of patient-related outcome measures in cohorts of patients who participated in IMPT programmes. Our second aim was to acquire insight into the heterogeneity of IMPT programmes. Databases and data treatment The study protocol was registered in Prospero under CRD42018076093. We searched Medline, Embase, PsycInfo and Cinahl from inception to May 2020. All study selection, data extraction and risk of bias assessments were independently performed by two researchers. Study cohorts were eligible if they included adult patients with chronic primary musculoskeletal pain for at least 3 months. We assessed the change over time, by calculating pre-post, post-follow-up and pre-follow-up contrasts for seven different patient-reported outcome domains. To explore the variability between the IMPT programmes, we summarized the patient characteristics and treatment programmes using the intervention description and replication checklist. Results The majority of the 72 included patient cohorts significantly improved during treatment. Importantly, this improvement was generally maintained at follow-up. In line with our expectations and with previous studies, we observed substantial methodological and statistical heterogeneity. Conclusions This study shows that participation in an IMPT programme is associated with considerable improvements in wellbeing that are generally maintained at follow-up. The current study also found substantial heterogeneity in dose and treatment content, which suggests different viewpoints on how to optimally design an IMPT programme. Significance The current study provides insight into the different existing approaches regarding the dose and content of IMPT programs. This analysis contributes to an increased understanding of the various approaches by which a biopsychosocial perspective on chronic pain can be translated to treatment programs. Furthermore, despite theoretical and empirical assertions regarding the difficulty to maintain newly learned health behaviors over time, the longitudinal analysis of health outcomes did not find a relapse pattern for patients who participated in IMPT programs
AB - Background and objectives Although Interdisciplinary Multimodal Pain Treatment (IMPT) programmes share a biopsychosocial approach to increase the wellbeing of patients with chronic pain, substantial variation in content and duration have been reported. In addition, it is unclear to what extent any favourable health outcomes are maintained over time. Therefore, our first aim was to identify and analyse the change over time of patient-related outcome measures in cohorts of patients who participated in IMPT programmes. Our second aim was to acquire insight into the heterogeneity of IMPT programmes. Databases and data treatment The study protocol was registered in Prospero under CRD42018076093. We searched Medline, Embase, PsycInfo and Cinahl from inception to May 2020. All study selection, data extraction and risk of bias assessments were independently performed by two researchers. Study cohorts were eligible if they included adult patients with chronic primary musculoskeletal pain for at least 3 months. We assessed the change over time, by calculating pre-post, post-follow-up and pre-follow-up contrasts for seven different patient-reported outcome domains. To explore the variability between the IMPT programmes, we summarized the patient characteristics and treatment programmes using the intervention description and replication checklist. Results The majority of the 72 included patient cohorts significantly improved during treatment. Importantly, this improvement was generally maintained at follow-up. In line with our expectations and with previous studies, we observed substantial methodological and statistical heterogeneity. Conclusions This study shows that participation in an IMPT programme is associated with considerable improvements in wellbeing that are generally maintained at follow-up. The current study also found substantial heterogeneity in dose and treatment content, which suggests different viewpoints on how to optimally design an IMPT programme. Significance The current study provides insight into the different existing approaches regarding the dose and content of IMPT programs. This analysis contributes to an increased understanding of the various approaches by which a biopsychosocial perspective on chronic pain can be translated to treatment programs. Furthermore, despite theoretical and empirical assertions regarding the difficulty to maintain newly learned health behaviors over time, the longitudinal analysis of health outcomes did not find a relapse pattern for patients who participated in IMPT programs
KW - LOW-BACK-PAIN
KW - 2-YEAR FOLLOW-UP
KW - QUALITY-OF-LIFE
KW - REHABILITATION PROGRAM
KW - FUNCTIONAL RESTORATION
KW - MULTIDISCIPLINARY REHABILITATION
KW - SELF-MANAGEMENT
KW - CLINICAL-TRIALS
KW - BODY AWARENESS
KW - SPINAL PAIN
U2 - 10.1002/ejp.1875
DO - 10.1002/ejp.1875
M3 - (Systematic) Review article
C2 - 34624159
SN - 1090-3801
VL - 26
SP - 310
EP - 335
JO - European Journal of Pain
JF - European Journal of Pain
IS - 2
ER -