Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Department of Research and Higher Education, Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.
Eur J Pain. 2021 Nov;25(10):2190-2201. doi: 10.1002/ejp.1832. Epub 2021 Jul 20.
Interdisciplinary treatment (IDT) is an internationally recommended intervention for chronic pain, despite inconclusive evidence of its effects on sickness absence.
With data from 25,613 patients in Swedish specialist healthcare, we compared sickness absence, in the form of both sick leave and disability pensions, over a 5-year period between patients either allocated to an IDT programme or to other/no interventions (controls). To obtain population-average estimates, a Markov multistate model with theory-based inverse probability weights was used to compute both the proportion of patients on sickness absence and the total sickness absence duration.
IDT patients were more likely than controls to receive sickness absence benefits at any given time (baseline: 49% vs. 46%; 5-year follow-up: 36% vs. 35%), and thereby also had a higher total duration, with a mean (95% CI) of 67 (87, 48) more days than controls over the 5-year period. Intriguingly, sick leave was higher in IDT patients (563 [552, 573] vs. 478 [466, 490] days), whereas disability pension was higher in controls (152 [144, 160] vs. 169 [161, 178] days).
Although sickness absence decreased over the study period in both IDT patients and controls, we found no support for IDT decreasing sickness absence more than other/no interventions in chronic pain patients.
In this large study of chronic pain patients in specialist healthcare, sickness absence is compared over a 5-year period between patients in an interdisciplinary treatment programme and other/no interventions. Sickness absence decreased over the study period in bothgroups; however, there was no support forthat it decreased more with interdisciplinary treatment than alternative interventions.
跨学科治疗（IDT）是一种国际推荐的慢性疼痛干预方法，尽管其对病假的影响证据尚不明确。
利用来自瑞典专科医疗的 25613 名患者的数据，我们比较了在 5 年内，接受 IDT 方案或其他/无干预（对照组）的患者的病假（包括病假和残疾抚恤金）情况。为了获得人群平均估计值，我们使用基于理论的逆概率加权的马尔可夫多状态模型来计算处于病假状态的患者比例和总病假持续时间。
与对照组相比，IDT 患者在任何给定时间接受病假福利的可能性更高（基线：49% vs. 46%；5 年随访：36% vs. 35%），因此病假总持续时间也更长，5 年内平均（95%CI）比对照组多 67（87，48）天。有趣的是，IDT 患者的病假天数更高（563 [552，573] vs. 478 [466，490]天），而对照组的残疾抚恤金天数更高（152 [144，160] vs. 169 [161，178]天）。
尽管在研究期间，IDT 患者和对照组的病假都有所减少，但我们没有发现 IDT 比其他/无干预更能减少慢性疼痛患者的病假。
在这项针对专科医疗慢性疼痛患者的大型研究中，我们比较了接受跨学科治疗方案和其他/无干预的患者在 5 年内的病假情况。在研究期间，两组的病假都有所减少；然而，没有证据表明 IDT 比其他干预措施更能减少病假。
