Factors associated with improvement in experienced eisabilities, pain intensity and quality of life after following an Interdisciplinary Pain Rehabilitation Programme - analysis of the Dutch Dataset Pain Rehabilitation

Abstract

Aim and background With a high prevalence in adults and great personal, social and economic burden, Chronic Musculoskeletal Pain (CMP) is a major problem. In The Netherlands, moderate to severe CMP-patients are offered an Interdisciplinary Special Pain Rehabilitation Programme (ISPRP), in which the Dutch Dataset Pain Rehabilitation is used for screening and evaluation purposes. This study aims to give insight in the effectiveness of ISPRP and factors associated with improvement of experienced disability (and pain intensity and quality of life). Methods Patient characteristics and Patient Reporter Outcome Measures (PROMs) of moderate to severe CMP-patients, collected as part of routine outcome monitoring in the period of 2013-2017, were described. Change-scores were calculated to give insight in the effectiveness. Multiple linear regression analysis were performed, using the patient characteristics and PROMs as possible factors and the change-scores of de PDI as primary, and NRS and two RAND36-subscales as secondary outcome measures. Results Patients reported positive change in all used PROMs after following ISPRP. Lower age, shorter duration of pain, more pain at worst and self-efficacy, less problems in physical functioning and mental health, avoidance and insufficiency of thinking and acting at screening are associated with more improvement on experienced disabilities. Conclusion and clinical relevance The results of this study demonstrate the small contribution of DDPR PROMs in the ISPRP-screening-process and support the need of early referral to ISPRP. This study also provides screening-information which can contribute to more transparent decision-making and increase of quality in pain-rehabilitation.