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Maintenance of quality of life improvement for patients with chronic pain and obesity after interdisciplinary multimodal pain rehabilitation : A study using the Swedish Quality Registry for Pain Rehabilitation

Dong, Huan Ji; Larsson, Britt LU ; Rivano Fischer, Marcelo LU and Gerdle, Björn (2019) In European Journal of Pain (United Kingdom)
Abstract

Background: Throughout the world many people have both obesity and chronic pain, comorbidities that decrease Health-Related Quality of Life (HRQoL). It is uncertain whether patients with comorbid obesity can maintain improved HRQoL after Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). Methods: Data from 2016, 2017, and 2018 were obtained from a national pain database for Swedish specialized pain clinics and collected at three time points: Pre-IMMPR; Post- IMMPR; and 12-month follow-up (FU-IMMPR). Participants (N = 872) reported body weight, height, pain aspects, and HRQoL (RAND 36-Item Health Survey). Severe obesity (Body Mass Index, BMI ≥35 kg/m2) was defined according to WHO classifications. We used linear mixed... (More)

Background: Throughout the world many people have both obesity and chronic pain, comorbidities that decrease Health-Related Quality of Life (HRQoL). It is uncertain whether patients with comorbid obesity can maintain improved HRQoL after Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). Methods: Data from 2016, 2017, and 2018 were obtained from a national pain database for Swedish specialized pain clinics and collected at three time points: Pre-IMMPR; Post- IMMPR; and 12-month follow-up (FU-IMMPR). Participants (N = 872) reported body weight, height, pain aspects, and HRQoL (RAND 36-Item Health Survey). Severe obesity (Body Mass Index, BMI ≥35 kg/m2) was defined according to WHO classifications. We used linear mixed regression models to examine BMI group differences in HRQoL over time. Results: More than 25% of patients (224/872) were obese and nearly 30% (63/224) of these were severely obese. All BMI groups improved significantly in both physical and mental composites of HRQoL after IMMPR (Pre- vs. Post-IMMPR, p <.001). The improvements were maintained at a 12-month follow-up (Post- vs. FU-IMMPR, p >.05). The severe obesity group had the lowest physical health score and least improvement (pre- vs. FU-IMMPR, Cohen's d = o.422, small effect size). Severe obesity had negative impact on physical health (β = −4.39, p <.05) after controlling for sociodemographic factors and pain aspects. Conclusion: Improvements in HRQoL after IMMPR were achieved and maintained across all weights, including patients with comorbid obesity. Only severe obesity was negatively associated with physical health aspects of HRQoL. Significance: Patients with chronic pain and comorbid obesity achieve sustained Health-Related Quality of Life (HRQoL) improvements from Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). This finding suggests that rehabilitation professionals should consider using IMMPR for patients with comorbid obesity even though their improvement may not reach the same level as for non-obese patients.

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publication status
epub
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in
European Journal of Pain (United Kingdom)
publisher
Elsevier
external identifiers
  • scopus:85070450678
ISSN
1090-3801
DOI
10.1002/ejp.1457
language
English
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yes
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b102cff1-a88c-4635-bdc9-d69899fb6940
date added to LUP
2019-08-26 12:49:52
date last changed
2019-09-17 04:59:25
@article{b102cff1-a88c-4635-bdc9-d69899fb6940,
  abstract     = {<p>Background: Throughout the world many people have both obesity and chronic pain, comorbidities that decrease Health-Related Quality of Life (HRQoL). It is uncertain whether patients with comorbid obesity can maintain improved HRQoL after Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). Methods: Data from 2016, 2017, and 2018 were obtained from a national pain database for Swedish specialized pain clinics and collected at three time points: Pre-IMMPR; Post- IMMPR; and 12-month follow-up (FU-IMMPR). Participants (N = 872) reported body weight, height, pain aspects, and HRQoL (RAND 36-Item Health Survey). Severe obesity (Body Mass Index, BMI ≥35 kg/m<sup>2</sup>) was defined according to WHO classifications. We used linear mixed regression models to examine BMI group differences in HRQoL over time. Results: More than 25% of patients (224/872) were obese and nearly 30% (63/224) of these were severely obese. All BMI groups improved significantly in both physical and mental composites of HRQoL after IMMPR (Pre- vs. Post-IMMPR, p &lt;.001). The improvements were maintained at a 12-month follow-up (Post- vs. FU-IMMPR, p &gt;.05). The severe obesity group had the lowest physical health score and least improvement (pre- vs. FU-IMMPR, Cohen's d = o.422, small effect size). Severe obesity had negative impact on physical health (β = −4.39, p &lt;.05) after controlling for sociodemographic factors and pain aspects. Conclusion: Improvements in HRQoL after IMMPR were achieved and maintained across all weights, including patients with comorbid obesity. Only severe obesity was negatively associated with physical health aspects of HRQoL. Significance: Patients with chronic pain and comorbid obesity achieve sustained Health-Related Quality of Life (HRQoL) improvements from Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). This finding suggests that rehabilitation professionals should consider using IMMPR for patients with comorbid obesity even though their improvement may not reach the same level as for non-obese patients.</p>},
  author       = {Dong, Huan Ji and Larsson, Britt and Rivano Fischer, Marcelo and Gerdle, Björn},
  issn         = {1090-3801},
  language     = {eng},
  month        = {01},
  publisher    = {Elsevier},
  series       = {European Journal of Pain (United Kingdom)},
  title        = {Maintenance of quality of life improvement for patients with chronic pain and obesity after interdisciplinary multimodal pain rehabilitation : A study using the Swedish Quality Registry for Pain Rehabilitation},
  url          = {http://dx.doi.org/10.1002/ejp.1457},
  year         = {2019},
}