Controlled 3-year follow-up of a multidisciplinary pain rehabilitation program in primary health care.
OBJECTIVE
The high prevalence of musculoskeletal pain generates significant costs for primary health care and the whole of society. The development of appropriate interventions is therefore necessary. The aim of this effectiveness study was to assess the long-term effects of a primary health care multidisciplinary rehabilitation program in Sweden.


METHODS
An experimental group comprising 89 patients from two primary health care units received individualised treatment interventions after a multidisciplinary investigation. A control group of 69 patients with the same inclusion criteria from four other primary health care units were treated according to routine. All participants completed questionnaires measuring pain, sick leave, quality of life, health care utilisation, drug consumption and psychosocial factors at baseline and at 3-year follow-up.


RESULTS
After 3 years, utilisation of primary health care was significantly lower in the experimental group and work capacity was slightly but not significantly higher. The control group showed a trend of having a higher risk of high consumption after 3 years compared to the intervention group. There was no significant difference between the two groups concerning remaining variables such as function, catastrophising and pain.


CONCLUSIONS
Both groups demonstrated considerable improvement over the course of 3 years. The experimental group had lower health care utilisation and a reduced risk of using large amounts of medication at the 3-year follow-up, indicating that compared with participants in the control group they were coping in a better way with pain.
Westman
Anders
A
Center for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden. anders.westman@ltv.se
Linton
Steven J
SJ
Ohrvik
John
J
Wahlén
Petra
P
Theorell
Töres
T
Leppert
Jerzy
J
D000704:Analysis of Variance; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation*; D010146:Pain / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation*; D010147:Pain Measurement; D011320:Primary Health Care / Q000706:statistics & numerical data; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013548:Sweden; D016896:Treatment Outcome