Evaluation of a multiprofessional rehabilitation programme for persistent musculoskeletal-related pain: Economic benefits of return to work

Norrefalk, Jan-Rickard; Ekholm, Karolina; Linder, Jürgen; Borg, Kristian; Ekholm, Jan

doi:10.2340/16501977-0131

Cited by 37 publications

(31 citation statements)

References 19 publications

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“…when loss of earnings and productivity losses are taken into account [96,97]. Comprehensive multidisciplinary assessment and management programmes are costly and there have been few well-designed evaluations with long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…The available studies are heterogeneous, of variable quality, and offer only limited evidence for an intermediate or long-term benefit or for cost-effectiveness [89,98-100]. Positive reports from Denmark [99,101,102] and Sweden [96] on a multi-professional approach to chronic non-cancer pain are supported by outcome data from a programme in Germany (preliminary data published in non-peer reviewed articles in the German language) [103,104]. In Finland, 46% of 439 patients had improved QoL after 6 months’ treatment in a multidisciplinary pain clinic, and benefits were shown to last for at least 3 years [105,106].…”

Section: Discussionmentioning

confidence: 99%

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The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care

2013

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BackgroundChronic pain is common in Europe and elsewhere and its under treatment confers a substantial burden on individuals, employers, healthcare systems and society in general. Indeed, the personal and socioeconomic impact of chronic pain is as great as, or greater, than that of other established healthcare priorities. In light of review of recently published data confirming its clinical and socioeconomic impact, this paper argues that chronic pain should be ranked alongside other conditions of established priority in Europe. We outline strategies to help overcome barriers to effective pain care resulting in particular from deficiencies in education and access to interdisciplinary pain management services. We also address the confusion that exists between proper clinical and scientific uses of opioid medications and their potential for misuse and diversion, as reflected in international variations in the access to, and availability of, these agents.DiscussionAs the economic costs are driven in part by the costs of lost productivity, absenteeism and early retirement, pain management should aim to fully rehabilitate patients, rather than merely to relieve pain. Accredited education of physicians and allied health professionals regarding state-of-the-art pain management is crucial. Some progress has been made in this area, but further provision and incentivization is required. We support a tiered approach to pain management, whereby patients with pain uncontrolled by non-specialists are able to consult a physician with a pain competency or a specialist in pain medicine, who in turn can recruit the services of other professionals on a case-by-case basis. A fully integrated interdisciplinary pain service should ideally be available to patients with refractory pain. Governments and healthcare systems should ensure that their policies on controlled medications are balanced, safeguarding public health without undue restrictions that compromise patient care, and that physician education programmes support these aims.SummaryStrategic prioritization and co-ordinated actions are required nationally and internationally to address the unacceptable and unnecessary burden of uncontrolled chronic pain that plagues European communities and economies. An appreciation of the ‘return on investment’ in pain management services will require policymakers to adopt a long-term, cross-budgetary approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care

2013

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“…In the control group the corresponding figure was 13-24%, (p < 0.001). Taking the number of working hours per day into account, the corresponding return-to-work rate measured in full-time jobs was 30.5 in the study group and 16 in the control group, a difference of 14.5 in the 67 pairs included in this study (p < 0.001) (Norrefalk et al, 2008).…”

Section: Shs Web Of Conferencesmentioning

confidence: 99%

“…The benefit of the program was estimated to be e3,799-7,515 (US $ 5,319-10,521) per treated patient and year in comparison to the control group (Norrefalk et al, 2008).…”

Section: Shs Web Of Conferencesmentioning

confidence: 99%

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Pain rehabilitation – outcome of an 8-week rehabilitation program

Norrefalk

Borg

2012

SHS Web of Conferences

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Abstract. The prevalence of persistent pain has been estimated to be around 20-50% in a normal population. Musculoskeletal related pain is the most common form of persistent pain. In patients with persistent pain there are alterations in the peripheral as well as the central nervous system and patients develop a dysfunctional behaviour which, in many cases, leads to severe suffering for the patient. In the European countries an increasing problem has emerged consisting of more people on long-term sick-leave, increased number of early retirements and high social costs. After an 8-week structured multiprofessional rehabilitation programme at the Karolinska Institute in Stockholm, Sweden 63% of patients with longstanding non-malignant pain returned to work and half of the patients were still at work at a 6-year follow-up. Half of the patients reported pain reduction and almost half of the patients had reduced their consumption of analgesics. The rehabilitation program was estimated as economically beneficial on a society level. It is concluded that pain rehabilitation should have a multiprofessional approach. Pain rehabilitation programs are beneficial for the possibility for the patient to return to work pain and leads to pain reduction in the long run. Furthermore, they are beneficial from a socio-economical aspect. Key words: persistent musculoskeletal pain, multiprofessional rehabilitation program, return to work, socio-economic benefitThe prevalence of persistent pain is estimated to be 20 and even up to 50 % in the normal population (Brattberg et al., 1989;Andersson et al., 1993;Gerdle et al., 2004;Elliott et al., 1999;Brevik et al., 2006 Suffering from pain over a long period of time negatively affects a person's family life, spare time, economy, psychosocial well-being and ability to work. It also leads to rising costs for society. Rehabilitation in a structured program with a multiprofessional team has shown beneficial effects on sick-leave, disability pension and /or return to work. The clinical effectiveness of such programs has also been documented in systematic reviews (Malone, Strube, 1988;Flor et al., 1992;Morley et al., 1999;Karjalainen et al., 2001;Karjalainen et al., 1999;Guzmán et al., 2001;Nielson, Weir, 2001;Marhold et al., 2001;Oliver, 2001;Shonstein et al., 2003; SBU, 2000; SBU, 2006; SBU, 2010).The Department of Rehabilitation Medicine at Huddinge University Hospital in Stockholm, Sweden, offered an 8-week multiprofessional work-related rehabilitation program for patients on long-term sickleave suffering from persistent musculoskeletal related pain.The objectives of the clinical rehabilitation program were: 1) return-to-work, 2) increased activity level, and 3) reduced pain intensity.The 8-week medical and work-related multiprofessional rehabilitation program ran 7.5 hours a day and 5 days a week.The program consisted of 2 parts: A 3-week Impairment and Disability Evaluation Analysis (IDEA) and a 5-week work-related program.The idea of the IDEA included the different tools of the multiprofes...

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Association of insomnia severity with well‐being, quality of life and health care costs: A cross‐sectional study in older adults with chronic pain (PainS65+)

Dragioti

Bernfort

Larsson

et al. 2017

European Journal of Pain

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Evaluation of a multiprofessional rehabilitation programme for persistent musculoskeletal-related pain: Economic benefits of return to work

Cited by 37 publications

References 19 publications

The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care

The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care

Pain rehabilitation – outcome of an 8-week rehabilitation program

Association of insomnia severity with well‐being, quality of life and health care costs: A cross‐sectional study in older adults with chronic pain (PainS65+)

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