Influences of Sex, Education, and Country of Birth on Clinical Presentations and Overall Outcomes of Interdisciplinary Pain Rehabilitation in Chronic Pain Patients: A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)

This study investigates the effects of sex, education, and country of birth on clinical presentations and outcomes of interdisciplinary multimodal pain rehabilitation programs (IMMRPs). A multivariate improvement score (MIS) and two retrospective estimations of changes in pain and ability to handle...

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Bibliographic Details
Published in:Journal of clinical medicine 2020, Vol.9 (8), p.2374
Main Authors: Gerdle, Björn, Boersma, Katja, Åsenlöf, Pernilla, Stålnacke, Britt-Marie, Larsson, Britt, Ringqvist, Åsa
Format: Article
Language:English
Subjects:
Chronic illnesses
Chronic pain
Clinical medicine
Cohort analysis
Country of birth
Education
Health care
interdisciplinary
Interdisciplinary aspects
Medicin och hälsovetenskap
outcome
Pain
Patients
Primary care
Questionnaires
Rehabilitation
sex
Sick leave
Variables
Womens health
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Summary:This study investigates the effects of sex, education, and country of birth on clinical presentations and outcomes of interdisciplinary multimodal pain rehabilitation programs (IMMRPs). A multivariate improvement score (MIS) and two retrospective estimations of changes in pain and ability to handle life situations were used as the three overall outcomes of IMMRPs. The study population consisted of chronic pain patients within specialist care in the Swedish Quality Registry for Pain Rehabilitation (SQRP) between 2008 and 2016 at baseline (n = 39,916), and for the subset participating in IMMRPs (n = 14,666). A cluster analysis based on sex, education, and country of origin revealed significant differences in the following aspects: best baseline clinical situation was for European women with university educations and the worst baseline clinical situation was for all patients born outside Europe of both sexes and different educations (i.e., moderate-large effect sizes). In addition, European women with university educations also had the most favorable overall outcomes in response to IMMRPs (small effect sizes). These results raise important questions concerning fairness and equality and need to be considered when optimizing assessments and content and delivery of IMMRPs for patients with chronic pain.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm9082374