Predictors for return to work after multimodal rehabilitation in persons with persistent musculoskeletal pain

Abstract

Aims: To identify factors explaining return to work (RTW) 12 months after a multimodal rehabilitation (MMR) intervention in the REHSAM II project. Methods: The present study is a secondary assessment of the data from the randomized controlled trial REHSAM II. A total of 97 participants with persistent musculoskeletal pain were randomly allocated to MMR + web-based education or only MMR. The subjects were followed from baseline to 12 months. The baseline variables from the outcome measures were used to identify predictors. The associations between the dependent variable (i.e., RTW) and independent variables (i.e., baseline variables) were analyzed with univariate and multiple logistic regression models. Results: The univariate regression analyses showed that pain and disability level, the capacity to perform a task in relation to pain, hospital and psychiatric care, medication for insomnia, catastrophizing, self-assessed work ability compared with lifetime best, satisfaction with life, ability for coping and controlling work situation, ability for coping with life outside work, and sense of responsibility for managing health condition were significantly associated with RTW. In the final multiple regression model, RTW was predicted by the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ score) (p=0.003, OR=0.961) and EuroQol (EQ-5D index) (p=0.017, OR=7.283) Conclusion: Psychosocially related pain and health-related quality of life predicted RTW in the final model. The results confirm that RTW is a multidimensional problem involving a complex interaction of many factors.