Multidisciplinary Intervention in Patients with Musculoskeletal Pain: a Randomized Clinical Trial.
BACKGROUND
Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term disability and reduced quality of life. The scientific literature on effects of treatment for musculoskeletal pain is inconclusive.


OBJECTIVE
The purpose of this study is to compare a multidisciplinary intervention (MI), including use of the novel Interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET), with a brief intervention (BI), on effects on mental and physical symptoms, functioning ability, use of health services and coping in patients sick-listed due to musculoskeletal pain.


METHODS
Two hundred eighty-four adults aged 18-60, referred to a specialist clinic in physical rehabilitation, were randomized to MI or BI. Patients received a medical examination at baseline and completed a comprehensive questionnaire at baseline, 3 months and 12 months.


RESULTS
Both groups reported improvements in mental and physical symptoms, including pain, and improved functioning ability at 3 and 12 months, but the MI group improved faster than the BI group except from reports of pain, which had a similar course. Significant interactions between group and time were found on mental symptoms (anxiety (p < 0.05), depression (p < 0.01), somatization (p < 0.01)) and functioning ability (p < 0.01) due to stronger effects in the MI group at 3 months. At 3 and 12 months, the MI group reported significantly less use of health services (general practitioner (p < 0.05)). At 12 months, the MI group reported better self-evaluated capability of coping with complaints (p < 0.001) and they took better care of their own health (p < 0.001), compared to the BI group.


CONCLUSIONS
The results indicate that the MI may represent an important supplement in the treatment of musculoskeletal pain.
Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Ottestad, Norway. randi.brendbekken@sykehuset-innlandet.no.
Randi
http://orcid.org/0000-0002-9608-7053
R
Brendbekken
Department of Health Promotion and Development, University of Bergen, Bergen, Norway.
Anette
A
Harris
Uni Research Health, Bergen, Norway.
Holger
H
Ursin
Department of Health Promotion and Development, University of Bergen, Bergen, Norway.|Uni Research Health, Bergen, Norway.
Hege R
HR
Eriksen
Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Bergen, Norway.
Tone
T
Tangen
D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D004185:Disability Evaluation; D019468:Disease Management; D005260:Female; D006801:Humans; D058025:Interdisciplinary Studies; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D010348:Patient Care Team / Q000458:organization & administration*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
Chronic musculoskeletal pain; Multidisciplinary treatment; Patient education tool; Randomized clinical trial