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The value of interdisciplinary treatment for sickness absence in chronic pain: A nationwide register-based cohort study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Center for Clinical Research Dalarna. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Alfred Nobels Alle 23, S-14183 Huddinge, Sweden.;Uppsala Univ, Ctr Clin Res Dalarna, Dept Res & Higher Educ, Falun, Region Dalama, Sweden..
Linköping Univ, Dept Hlth Med & Caring Sci, Pain & Rehabil Ctr, Linköping, Sweden..
Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden..
Konstfack Univ Arts Crafts & Design, Dept Arts & Crafts, Stockholm, Sweden..
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2021 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 25, no 10, p. 2190-2201Article in journal (Refereed) Published
Abstract [en]

Background Interdisciplinary treatment (IDT) is an internationally recommended intervention for chronic pain, despite inconclusive evidence of its effects on sickness absence. Methods With data from 25,613 patients in Swedish specialist healthcare, we compared sickness absence, in the form of both sick leave and disability pensions, over a 5-year period between patients either allocated to an IDT programme or to other/no interventions (controls). To obtain population-average estimates, a Markov multistate model with theory-based inverse probability weights was used to compute both the proportion of patients on sickness absence and the total sickness absence duration. Results IDT patients were more likely than controls to receive sickness absence benefits at any given time (baseline: 49% vs. 46%; 5-year follow-up: 36% vs. 35%), and thereby also had a higher total duration, with a mean (95% CI) of 67 (87, 48) more days than controls over the 5-year period. Intriguingly, sick leave was higher in IDT patients (563 [552, 573] vs. 478 [466, 490] days), whereas disability pension was higher in controls (152 [144, 160] vs. 169 [161, 178] days). Conclusion Although sickness absence decreased over the study period in both IDT patients and controls, we found no support for IDT decreasing sickness absence more than other/no interventions in chronic pain patients. Significance In this large study of chronic pain patients in specialist healthcare, sickness absence is compared over a 5-year period between patients in an interdisciplinary treatment programme and other/no interventions. Sickness absence decreased over the study period in bothgroups; however, there was no support forthat it decreased more with interdisciplinary treatment than alternative interventions.

Place, publisher, year, edition, pages
WILEY John Wiley & Sons, 2021. Vol. 25, no 10, p. 2190-2201
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Public Health, Global Health and Social Medicine
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URN: urn:nbn:se:uu:diva-470060DOI: 10.1002/ejp.1832ISI: 000675153400001PubMedID: 34189810OAI: oai:DiVA.org:uu-470060DiVA, id: diva2:1650549
Funder
Swedish Research Council, Vetenskapsradet: 2015-02512Forte, Swedish Research Council for Health, Working Life and Welfare, FORTE: 2016-07414Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00177Available from: 2022-04-07 Created: 2022-04-07 Last updated: 2025-02-20Bibliographically approved

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Äng, Björn

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