title: Patterns of sickness absence a decade after pain-related multidisciplinary rehabilitation.
abstract: Multidisciplinary programmes using a vocational approach can enhance work return in chronic pain patients, but little is known about the long-term effects of rehabilitation. The current study examined the patterns of sickness absence 10 years after participation in 3 treatment groups (physiotherapy, cognitive behavioural therapy, and vocational multidisciplinary rehabilitation) in comparison to a control group receiving treatment-as-usual. Cost-effectiveness was also assessed. Two hundred fourteen patients participated in a randomized controlled trial and were followed-up via register data 10 years after the interventions. On average, persons in multidisciplinary rehabilitation had 42.98 fewer days on sickness absence per year compared to those treated-as-usual (95% confidence interval -82.45 to -3.52, P=0.03). The corresponding reduction of sickness absence after physiotherapy and cognitive behavioural therapy was not significantly different from the control group. The effect of rehabilitation seems to be more pronounced for disability pension than for sick leave. The economic analyses showed substantial cost savings for individuals in the multidisciplinary group compared to the control group.
authors.affiliation: Division of Intervention and Implementation Research, Department of Public Health, Karolinska Institutet, Sweden.
authors.forename: Hillevi
authors.initials: H
authors.lastname: Busch
authors.forename: Lennart
authors.initials: L
authors.lastname: Bodin
authors.forename: Gunnar
authors.initials: G
authors.lastname: Bergström
authors.forename: Irene B
authors.initials: IB
authors.lastname: Jensen
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D019988:Children with Disabilities / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000191:economics / Q000534:rehabilitation*; D010349:Patient Compliance / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000191:economics; D012189:Retrospective Studies; D018582:Sick Leave / Q000191:economics; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult