Constan Lea, Frumento Paolo, LoMartire Riccardo
Independent Researcher, Sweden.
Department of Political Sciences, University of Pisa, Pisa, Italy.
PLoS One. 2025 Feb 4;20(2):e0317797. doi: 10.1371/journal.pone.0317797. eCollection 2025.
Studies evaluating the effects of interdisciplinary treatment (IDT) on sickness absence and disability pension (SA/DP) have yielded contradictory findings. Evidence indicates that positive treatment effects are restricted to patients with a poor SA/DP prognosis. This study therefore analyzed the effect of IDT in working age patients on partial disability pension, which is a group with a particularly poor prognosis. With data from 479 patients on partial disability pension, this register-based cohort study compared the effects of IDT to those of unspecified interventions. We considered two response variables: total net SA/DP days across the span of three years from the first visit to a Swedish specialist pain clinic, and the risk of having the maximum possible 1096 SA/DP days over the same period. Our results showed that both the total net SA/DP days (mean difference: 11; 95% confidence interval: -30 to 51) and the risk of 1096 SA/DP days (risk ratio: 1.0; 95% confidence interval: 0.6 to 1.4) were similar irrespective of intervention type. Under our theoretical model, we thereby found no support in favor of IDT over less intensive interventions in working age patients with partial DP. This raises questions about the specific criteria under which IDT proves effective.
评估跨学科治疗(IDT)对病假和残疾抚恤金(SA/DP)影响的研究得出了相互矛盾的结果。有证据表明,积极的治疗效果仅限于SA/DP预后较差的患者。因此,本研究分析了IDT对处于工作年龄的部分残疾抚恤金患者的影响,这是一个预后特别差的群体。利用479名领取部分残疾抚恤金患者的数据,这项基于登记的队列研究比较了IDT与未明确干预措施的效果。我们考虑了两个反应变量:从首次就诊瑞典专科疼痛诊所起三年内的总净SA/DP天数,以及在同一时期内出现最多可能的1096个SA/DP天数的风险。我们的结果表明,无论干预类型如何,总净SA/DP天数(平均差异:11;95%置信区间:-30至51)和出现1096个SA/DP天数的风险(风险比:1.0;95%置信区间:0.6至1.4)都是相似的。在我们的理论模型下,我们因此发现在患有部分DP的工作年龄患者中,没有证据支持IDT比强度较低的干预措施更有效。这引发了关于IDT被证明有效的具体标准的问题。