Interdisciplinary Rehabilitation for Chronic Pain in Primary Healthcare
Study Details
Study Description
Brief Summary
Purpose: The overall aim is to investigate the effect of interdisciplinary rehabilitation in primary health care (PHC) for patients with chronic pain. Specific questions: What is the effect of extended access to the interdisciplinary PHC pain team + a booster session after finishing the rehabilitation program? Does participation in PHC interdisciplinary rehabilitation contribute to health improvements and are there predictors of this? Method: A randomized controlled trial (RCT). 200 patients with chronic pain that participate in interdisciplinary rehabilitation in primary healthcare in Region Västra Götaland (VGR) in Sweden will be included in the RCT and randomized to Intervention; standard care by the interdisciplinary teams in PHC + extended access to the team and a booster session 3 months after the end of the rehabilitation, or Control; only standard care by the interdisciplinary teams. Outcomes are health related quality of life, pain intensity and other health aspects.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The participants will be randomly allocated to intervention or active control. All participants in both arms receive the standard care for interdisciplinary rehabilitation at any of the six PHC pain teams in VGR. The teams consist of a physician, physiotherapist, occupational therapist and psychologist. All teams provide person-centred rehabilitation, aiming to increase physical activity and support behavioural changes, and to decrease symptoms and the impact of pain on the patients´ daily lives. The standard care interdisciplinary rehabilitation period contains both theoretical and practical components such as patient education, physical exercise and behavioural interventions. The sessions are mainly group-based. The duration of the rehabilitation period varies between 5 to 7 weeks + a follow-up visit after 3 months.
The participants in the intervention arm also receive an extra booster-session 3 months after the standard follow-up. At the booster-session, the participant´s individual rehabilitation plan is followed-up and adjusted. This extra period also includes extended access to the team, meaning that the participants have the possibility to contact the team and, if needed, have digital or telephone contact.
The participants complete a battery of questionaires included in the Swedish Quality Registry for Pain Rehabilitation an also extra questionnaires provided to the participants through an electronic research form.
Data collection is made at baseline before starting the rehabilitation, directly after the 5 to 7 weeks rehabilitation period and 6, 12 and 24 months after baseline.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Interdisciplinary rehabilitation + booster-session (intervention) Standard care by the interdisciplinary rehabilitation teams in primary healthcare + extended access to the team and a booster visit after 3 months. |
Other: Interdisciplinary care + booster session (intervention)
Standard care for interdisciplinary rehabilitation at any of the six interdisciplinary teams in primary health care in Region Västra Götaland, Sweden + one extra booster-session 3 months after the standard care rehabilitation. At the booster-session, the participant´s individual rehabilitation plan is followed-up and adjusted. This extra period also includes extended access to the team, meaning that the participants have the possibility to contact the team and, if needed, have digital or telephone contact.
|
| Active Comparator: Interdisciplinary rehabilitation (control) Standard care by the interdisciplinary rehabilitation teams in primary healthcare. |
Other: Interdisciplinary care (control)
Standard care for interdisciplinary rehabilitation at any of the six interdisciplinary teams in primary health care in Region Västra Götaland, Sweden.
|
Outcome Measures
Primary Outcome Measures
- Pain intensity [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
Assessed with visual analog scale and numeric rating scale
- Health related quality of life [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
Assessed with RAND-36, EQ5D-3L, EQ-VAS
Secondary Outcome Measures
- Pain spread [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The participants mark in boxes painful areas.
- Pain acceptance [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The Chronic pain acceptance questionnaire
- Self-efficacy [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The Pain self-efficacy questionnaire short-form
- Symptoms of stress [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The stress and crisis inventory (SCI-93)
- Physical activity [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The Godin questionnaire
- Anxiety and depression [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The hospital anxiety and depression scale
- Self-rated function [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The Functional rating index
- Work ability [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
One question from the Work ability index
- Life satisfaction [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The LiSat questionnaire
- Fatigue [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The multidimensional fatigue inventory
- Pain catastrophizing [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
The pain catastrophizing scale
- Patients´ own impression of change [Baseline, directly after the rehabilitation period and 6, 12 and 24 months from baseline.]
Patient global impression of change
- Health care use [From 12 months before to 24 months after the rehabilitation period]
Health care visit statistics
- Sickness abscence [From 12 months before to 24 months after the rehabilitation period]
Sickness absence data
Eligibility Criteria
Criteria
Inclusion Criteria:
- Persons participating in interdisciplinary team rehabilitation in primary healthcare in Region Västra Götaland, Sweden.
Exclusion Criteria:
- Severe psychiatric disease, language difficulties that makes it impossible to complete the questionnaires
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Research and development primary health care Fyrbodal | Vänersborg | Region Västra Götaland | Sweden | 46235 |
Sponsors and Collaborators
- Vastra Gotaland Region
Investigators
- Principal Investigator: Anna Bergenheim, Dr, Research and development primary healthcare Fyrbodal, region Västra Götaland, Sweden
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- Painteam