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 (SQRP)

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 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<0.001). The improvements were maintained at a 12‐month follow‐up (Post‐ vs. FU‐IMMPR, P>0.05). The severe obesity group had the lowest physical health score and least improvement (pre‐ vs. FU‐IMMPR, Cohen's d= 0.422, small effect size). Severe obesity had negative impact on physical health (β=‐4.39, P<0.05) 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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