The effect of interdisciplinary treatment on sickness absence and disability pension among chronic pain patients on partial disability pension

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 eff...

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Published in:	PloS one Vol. 20; no. 2; p. e0317797
Main Authors:	Constan, Lea, Frumento, Paolo, LoMartire, Riccardo
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 04.02.2025 Public Library of Science (PLoS)
Subjects:	Adult Biology and Life Sciences Chronic pain Chronic Pain - economics Chronic Pain - therapy Clinics Cohort Studies Disability pensions Female Health aspects Humans Illnesses Insurance agencies Interdisciplinary aspects Intervention Male Medicine and Health Sciences Middle Aged Occupational training Pain Patients Pensions Pensions - statistics & numerical data People and places Persons with Disabilities Prognosis Regression analysis Risk Sick Leave - statistics & numerical data Social aspects Social Sciences Sociodemographics Sweden Tumors Worker absenteeism Sweden
ISSN:	1932-6203, 1932-6203
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Abstract	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.
AbstractList	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.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. 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.
Audience	Academic
Author	Constan, Lea Frumento, Paolo LoMartire, Riccardo
AuthorAffiliation	1 Independent Researcher, Sweden Center for Research and Technology Transfer, VIETNAM 3 Center for Clinical Research Dalarna – Uppsala University, Falun, Region Dalarna, Sweden 4 School of Health and Welfare, Dalarna University, Falun, Sweden 2 Department of Political Sciences, University of Pisa, Pisa, Italy
AuthorAffiliation_xml	– name: 2 Department of Political Sciences, University of Pisa, Pisa, Italy – name: 1 Independent Researcher, Sweden – name: Center for Research and Technology Transfer, VIETNAM – name: 3 Center for Clinical Research Dalarna – Uppsala University, Falun, Region Dalarna, Sweden – name: 4 School of Health and Welfare, Dalarna University, Falun, Sweden
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Cites_doi	10.1007/s10926-017-9727-9 10.1002/ejp.1875 10.1177/02692155211005387 10.1016/S0140-6736(21)00393-7 10.1186/s12891-022-05807-7 10.1186/s12913-015-0740-4 10.2340/16501977-2765 10.2202/1557-4679.1285 10.1093/pubmed/fdaa112 10.1016/S0304-3959(01)00374-8 10.1007/978-3-319-19425-7 10.1007/s10926-016-9634-5 10.1016/j.puhe.2012.05.014 10.1186/1471-2458-13-1229 10.3389/fpain.2023.1177070 10.1097/j.pain.0000000000000902 10.1093/ije/dyu029 10.1177/1403494817722290 10.1080/030097498441128 10.3390/ijerph15112424 10.1186/1471-2458-11-450 10.1056/NEJMp2113319 10.1093/rheumatology/ken021 10.1007/s10654-019-00511-8 10.2147/JPR.S303186 10.1016/j.pain.2011.02.004 10.1097/00007632-199806010-00004 10.1007/s00586-010-1518-3 10.1016/j.jpain.2021.03.145 10.1097/00007632-199705010-00011 10.1136/bmj.h444
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Copyright	Copyright: © 2025 Constan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. COPYRIGHT 2025 Public Library of Science 2025 Constan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2025 Constan et al 2025 Constan et al 2025 Constan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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SubjectTerms	Adult Biology and Life Sciences Chronic pain Chronic Pain - economics Chronic Pain - therapy Clinics Cohort Studies Disability pensions Female Health aspects Humans Illnesses Insurance agencies Interdisciplinary aspects Intervention Male Medicine and Health Sciences Middle Aged Occupational training Pain Patients Pensions Pensions - statistics & numerical data People and places Persons with Disabilities Prognosis Regression analysis Risk Sick Leave - statistics & numerical data Social aspects Social Sciences Sociodemographics Sweden Tumors Worker absenteeism
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Title	The effect of interdisciplinary treatment on sickness absence and disability pension among chronic pain patients on partial disability pension
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