Background: Knee and hip osteoarthritis (OA) among older adults account for substantial disability and extensive healthcare use. Effective pain coping strategies help to deal with OA. This study aims to determine the long-term relationship between pain coping style and the course of healthcare use in patients with knee and/or hip OA over 10 years. Methods: Baseline and 10-year follow-up data of 861 Dutch participants with early knee and/or hip OA from the Cohort Hip and Cohort Knee (CHECK) cohort were used. The amount of healthcare use (HCU) and pain coping style were measured. Generalized Estimating Equations were used, adjusted for relevant confounders. Results: At baseline, 86.5% of the patients had an active pain coping style. Having an active pain coping style was significantly (p = 0.022) associated with an increase of 16.5% (95% CI, 2.0–32.7) in the number of used healthcare services over 10 years. Conclusion: Patients with early knee and/or hip OA with an active pain coping style use significantly more different healthcare services over 10 years, as opposed to those with a passive pain coping style. Further research should focus on altered treatment (e.g., focus on self-management) in patients with an active coping style, to reduce HCU.
DOCUMENT
Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Methods Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Results Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. Conclusion This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.
DOCUMENT
Objective: To explore predictors of dropout of patients with chronic musculoskeletal pain from an interdisciplinary chronic pain management programme, and to develop and validate a multivariable prediction model, based on the Extended Common- Sense Model of Self-Regulation (E-CSM). Methods: In this prospective cohort study consecutive patients with chronic pain were recruited and followed up (July 2013 to May 2015). Possible associations between predictors and dropout were explored by univariate logistic regression analyses. Subsequently, multiple logistic regression analyses were executed to determine the model that best predicted dropout. Results: Of 188 patients who initiated treatment, 35 (19%) were classified as dropouts. The mean age of the dropout group was 47.9 years (standard deviation 9.9). Based on the univariate logistic regression analyses 7 predictors of the 18 potential predictors for dropout were eligible for entry into the multiple logistic regression analyses. Finally, only pain catastrophizing was identified as a significant predictor. Conclusion: Patients with chronic pain who catastrophize were more prone to dropout from this chronic pain management programme. However, due to the exploratory nature of this study no firm conclusions can be drawn about the predictive value of the E-CSM of Self-Regulation for dropout.
DOCUMENT
De zorg voor de 1.6 miljoen mensen met chronische musculoskeletale pijn in Nederland kan en moet beter. Hoewel fysio- en oefentherapeuten een belangrijke rol hebben in het herstel van mensen met chronische musculoskeletale pijn is de biomedische aanpak die veelal wordt gekozen niet in lijn met de nieuwste wetenschappelijke inzichten en praktijkrichtlijnen. Veel eerstelijns zorgverleners voelen zich op dit moment incompetent bij het integreren van biopsychosociale factoren in diagnostiek en behandeling bij deze patiëntengroep. Daarom is de vraag uit de beroepspraktijk: Hoe kunnen fysio- en oefentherapeuten in de eerste lijn beter in staat worden gesteld om mensen te herkennen die beperkt zijn door chronische pijn, een inschatting te maken van de complexiteit van de klachten, en te behandelen vanuit een biopsychosociale visie? Het project is opgedeeld in drie fasen. Al eerste zullen bestaande eerstelijns biopsychosociale Beweegzorg interventies in kaart worden gebracht met behulp een scoping review. Het doel hiervan is om kennishiaten te identificeren, maar ook om een set van kennis en vaardigheden op te stellen die essentieel is voor een effectieve behandeling. De tweede fase zal bestaan uit het ontwikkelen van een compleet scholingsprogramma, inclusief ondersteunende materialen zoals richtlijnen, vragenlijsten, oefeningen en intervisie-structuren. Dit totaalpakket stelt fysiotherapeuten in staat om een state-of-the-art biopsychosociale interventie vorm te geven die aansluit op de specifieke hulpvraag en de persoonlijke context patiënten. In de derde fase zal deze aanpak worden getest in een feasibility studie, met als doel om inzicht te krijgen in de haalbaarheid van het scholingsprogramma en de biopsychosociaal georiënteerde interventies. Met behulp van dit project zal er een beweging worden gemaakt in de richting van eerstelijns Beweegzorg op maat, die inhoudelijk aansluit op de tweede- en derdelijns behandelprincipes. Daarnaast is het de ambitie van dit consortium om de inzichten uit dit project breed te verspreiden over aankomende en huidige zorgprofessionals.
