title: Predictors of outcome of multidisciplinary treatment in chronic widespread pain: an observational study.
abstract: BACKGROUND
  The effectiveness of multidisciplinary treatment in chronic widespread pain (CWP) is limited. The considerable heterogeneity among patients is a likely explanation. Knowledge on predictors of the outcome of multidisciplinary treatment can help to optimize treatment effectiveness. The purpose of this study was to identify predictors of multidisciplinary treatment outcome in patients with CWP.
  
  
  METHODS
  Data were used from baseline and 6 months follow-up measurements of a prospective cohort study of 120 CWP. Regression models were used to assess whether baseline variables predicted treatment outcome. Outcome domains included: pain, pain interference, depression, and global perceived effect (GPE). Potential predictors included: psychological distress, illness and self-efficacy beliefs, fear-avoidance beliefs and behaviour, symptoms, disability, and socio-demographic factors.
  
  
  RESULTS
  Greater improvement in pain was predicted by more pain at baseline and male gender. Greater improvement in interference of pain in daily life was predicted by more interference of pain in daily life at baseline, lower levels of anxiety, a stronger belief in personal control, less belief in consequences, male gender, and a higher level of education. Greater improvement in depression was predicted by higher baseline values of depression, stronger beliefs in personal control, and a higher level of education. Better outcome on GPE was predicted by less pain, less fatigue, and a higher level of education.
  
  
  CONCLUSIONS
  Less anxiety, stronger beliefs in personal control, less belief in consequences, less pain, less fatigue, higher level of education, and male gender are predictors of better outcome of multidisciplinary treatment in CWP. Tailoring treatment to these specific patient characteristics or selecting eligible patients for multidisciplinary treatment may further improve treatment outcome.
authors.forename: Aleid
authors.initials: A
authors.lastname: de Rooij
authors.forename: Marike
authors.initials: M
authors.lastname: van der Leeden
authors.forename: Leo D
authors.initials: LD
authors.lastname: Roorda
authors.forename: Martijn Pm
authors.initials: MP
authors.lastname: Steultjens
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D015331:Cohort Studies; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020377:Self Efficacy; D016896:Treatment Outcome; D055815:Young Adult