Does Nonsurgical Pain Center Treatment of Chronic Pain Return Patients to Work?

Cutler, Robert; Fishbain, David A.; Rosomoff, Hubert L.; Abdel-Moty, Elsayed; Khalil, Tarek M.; Rosomoff, Reneé Steele

doi:10.1097/00007632-199403001-00002

Cited by 140 publications

(44 citation statements)

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“…Another 16 articles (56-71) were included by screening the references of the retrieved studies and of reviews about back schools (6,7,72), pain treatment centers (73)(74)(75), occupational rehabilitation (8,76) and spinal manipulation (9,10).…”

Section: Resulfsmentioning

confidence: 99%

Vocational outcome of intervention for low-back pain

Weide¹,

Verbeek²,

Tulder³

1997

Scand J Work Environ Health

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Section: Resulfsmentioning

confidence: 99%

Vocational outcome of intervention for low-back pain

Weide¹,

Verbeek²,

Tulder³

1997

Scand J Work Environ Health

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“…There seems, however, to be a large variety in research results on RTW rates. A metaanalysis 6 on RTW after a multidisciplinary team approach in chronic pain showed that the proportions of patients working at follow-up varied between 6% 7 and 92%. 8 Different inclusion criteria and varying definitions for RTW and legislation and cultural differences may have influenced these results.…”

mentioning

confidence: 99%

Effectiveness of a Multidisciplinary Occupational Training Program for Chronic Low Back Pain

Koopman

Edelaar

Slikker

et al. 2004

American Journal of Physical Medicine & Rehabilitation

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Objective: To evaluate the effectiveness of a 12-wk multidisciplinary occupational training program for patients with chronic low back pain and to identify prognostic factors for treatment success.Design: A total of 51 participants were evaluated at baseline, at discharge, and at 1 yr after conclusion of the program. The evaluation included a physical examination and assessment of functional disability, psychological factors, and coping styles. The main target of the program is full work resumption. The central outcome measures therefore are three variables on return to work.Results: Analysis of variance for repeated measures revealed significant beneficial changes during the program for all measures except for several coping-style variables. The acquired level of maximum oxygen uptake, trunk flexibility, functional disability, and catastrophizing were maintained at 1-yr follow-up. At 1-yr follow-up, Ͼ60% of the participants had fully returned to work, which is an increase of Ͼ40% compared with baseline. Regression analyses showed that sex, age, the baseline values of reinterpretation of pain sensations, and functional disability and changes in trunk flexibility scores during the program are important prognostic factors for complete return to work.Conclusions: Based on the current findings, the program seems to be efficacious in the short term. Future attention must be directed toward maintaining these results, although work resumption rates improved considerably 1 yr after conclusion of the program.

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“…In some cases evidence on effectiveness comes from a review of the literature, 6 or from a meta-analysis which synthesises data from a variety of primary clinical studies. 5,27,28 By pooling a number of such studies, meta-analyses achieve large sample sizes and thus make it possible to detect small differences in effects, but it is crucial to ensure that the treatments are comparable, the original studies have been conducted properly, the bias to which they are subject has been minimised, and that differences in setting are acknowledged. 22,29,30 Costing Costing involves measuring the quantities of resources consumed to obtain a cost per patient.…”

Section: Effectivenessmentioning

confidence: 99%

Health Economics and Orthopaedics

Maniadakis

Gray

2000

The Journal of Bone and Joint Surgery. British volume

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It is becoming widely accepted that research which considers only the outcome and not the costs associated with new technologies in health care, is of limited value in making decisions about the use of scarce resources. Economic evaluation is becoming a standard feature of clinical research but many published economic evaluations fall short of best practice in their methodology. We have described the essential features of economic evaluation, using published studies in orthopaedics, in order to try to improve the ability of orthopaedic surgeons to read, understand and appraise such studies critically, and to encourage them to consider including economic evaluation in future investigations. J Bone Joint Surg [Br] 2000;82-B:2-8. Received 20 October 1998; Accepted after revision 23 July 1999Over the last three decades the demand for health care has increased rapidly. Since resources are scarce and cannot meet all demands, it is important to ensure that they are allocated in ways which maximise overall social benefit. The decision on which procedures to adopt depends upon their cost-effectiveness. Thus, economic evaluation of interventions in health care is now becoming common. It is concerned with the systematic comparison of the costs of the resource and the outcomes of alternative interventions, including drugs, devices, equipment and supplies, clinical procedures and organisational and managerial systems.In orthopaedics new technologies are emerging rapidly and these are often more expensive than existing treatments. Considerations of cost-effectiveness are therefore unavoidable. Economic evaluation in orthopaedics has been less common than in other areas of medicine, such as cardiology or oncology, but this is almost certain to change. In this review we outline how economic evaluation has been used so far in orthopaedics, and highlight the key points which should be considered in pursuing such studies. We wish to try to improve the ability of orthopaedic surgeons to read, understand and appraise published economic evaluations critically, but we also hope to encourage them to consider using such information in their future investigations.

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Does Nonsurgical Pain Center Treatment of Chronic Pain Return Patients to Work?

Cited by 140 publications

References 0 publications

Vocational outcome of intervention for low-back pain

Vocational outcome of intervention for low-back pain

Effectiveness of a Multidisciplinary Occupational Training Program for Chronic Low Back Pain

Health Economics and Orthopaedics

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