title: Improved quality of life, working ability, and patient satisfaction after a pretreatment multimodal assessment method in patients with mixed chronic muscular pain: a randomized-controlled study.
abstract: OBJECTIVE
  To investigate whether a pretreatment multimodal (MM) assessment of patients with chronic muscular pain has an impact on treatment outcome.
  
  
  METHODS
  The present randomized-controlled study evaluated an MM assessment compared with routine multidisciplinary assessment given to a control group. The study population consisted of primary care patients with mixed chronic muscular pain. Variables assessed were: pain intensity, depression, life stress, quality of life (QOL), disability, working ability, and treatment satisfaction. Follow-up was performed at 15 months and 182 patients of 220 (83%) completed the study.
  
  
  RESULTS
  Univariate and multivariate logistic regression showed from baseline to 15 months a significant improvement in QOL as measured by Short-Form 36 in the MM group compared with the control group on the domains of physical function (odds ratio 2.40; 95% confidence interval 1.32-4.37), role physical (2.37; 1.10-5.09), and role emotional (2.05; 1.05-3.96). Working ability improved more significantly in the MM group (46% vs. 35%) and impairment was less (1% vs. 15%) compared with the control group (P=0.016). Satisfaction with the assessment was, on average, higher (P<0.001) in the MM group than in the control group.
  
  
  CONCLUSIONS
  Patients who underwent an MM assessment before treatment in comparison with patients receiving routine multidisciplinary assessment improved QOL, working ability, and were also significantly more satisfied. This result indicates that MM pretreatment assessment could be advantageous in the selection of patients for suitable rehabilitation treatment in a primary care setting, and also be used to prepare patients for future rehabilitation.
authors.affiliation: Psychosomatic Medicine Clinic and Centre for Clinical Research, Uppsala University, Central Hospital, Västerås, Sweden. mats.rothman@ltv.se
authors.forename: Mats Georg
authors.initials: MG
authors.lastname: Rothman
authors.forename: Monica
authors.initials: M
authors.lastname: Ortendahl
authors.forename: Andreas
authors.initials: A
authors.lastname: Rosenblad
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Johansson
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011788:Quality of Life; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D014938:Work Capacity Evaluation; D014940:Work Schedule Tolerance