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Does pain severity guide selection to multimodal pain rehabilitation across gender?
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Norwegian Inst Publ Hlth, Div Mental Hlth, Dept Publ Mental Hlth, Bergen, Norway.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Norwegian Inst Publ Hlth, Div Mental Hlth, Dept Publ Mental Hlth, Bergen, Norway. (Umeå Centre for Gender Studies in Medicine)
2015 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 19, no 6, 826-833 p.Article in journal (Refereed) Published
Abstract [en]

Background Studies have addressed the effect of multimodal pain rehabilitation (MMR), whereas criteria for selection are sparse. This study examines whether higher scores on musculoskeletal pain measures are associated with selection to MMR, and whether this differs across gender.

Method A clinical population of 262 male and 589 female patients was recruited consecutively during 3 years, 2007-2010. The patients were referred from primary care to a pain rehabilitation clinic in Northern Sweden for assessment and selection to MMR. Register-based data on self-reported pain were linked to patients' records where outcome (MMR or not) was stated. We modelled odds ratios for selection to MMR by higher scores on validated pain measures (pain severity, interference with daily life, pain sites and localized pain vs. varying pain location). Covariates were age, educational level and multiple pain measures. Anxiety and depression (Hospital, Anxiety and Depression Scale) and working status were used in sensitivity tests.

Results Higher scores of self-reported pain were not associated with selection to MMR in multivariate models. Among women, higher scores on pain severity, pain sites and varying pain location (localized pain=reference) were negatively associated with selection to MMR. After adjustment for multiple pain measures, the negative odds ratio for varying location persisted (OR=0.59, 95% CI=0.39-0.89).

Conclusion Higher scores on self-reported pain did not guide selection to MMR and a negative trend was found among women. Studies of referral patterns and decision processes may contribute to a better understanding of the clinical practice that decides selection to MMR.

Place, publisher, year, edition, pages
2015. Vol. 19, no 6, 826-833 p.
National Category
Anesthesiology and Intensive Care Neurology Neurosciences
Identifiers
URN: urn:nbn:se:umu:diva-106253DOI: 10.1002/ejp.609ISI: 000354128300013PubMedID: 25366906OAI: oai:DiVA.org:umu-106253DiVA: diva2:841378
Available from: 2015-07-13 Created: 2015-07-09 Last updated: 2017-12-04Bibliographically approved

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Stålnacke, Britt-MarieHammarström, Anne

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