Papers of the Week

Interdisciplinary treatment is a widely implemented strategy for the rehabilitation of patients with chronic pain. A primary treatment objective is to decrease the load on the social insurance system; however, it is questionable whether interdisciplinary treatment reduces sickness absence and disability pension. This register-based observational study compared sickness absence and disability pension between patients in interdisciplinary treatment and unspecified interventions. With data from 7,752 Swedish specialist healthcare patients in their prime working age, we analyzed total net sickness absence and disability pension days over three years from the first visit to a pain rehabilitation center. A zero-one-inflated beta model, adjusted for theoretically substantiated confounders, was used to estimate the mean differences in total days and in the proportions of patients with both zero and the maximum days. Compared with unspecified interventions, interdisciplinary treatment resulted in a mean (95% confidence interval) absolute increase of 50 (37, 62) total days, a 13.0% (11.3%, 14.6%) decrease in patients with zero days, and a 1.5% (0.2%, 2.8%) decrease in patients with the maximum days. These findings support that interdisciplinary treatment increases sickness absence and disability pension compared to less intensive interventions, but reduces the risk of maximum days, implying that it is advantageous for patients with the highest absence. This highlights the need for improved patient selection procedures and the adaptation of interdisciplinary treatment programs to more adequately target sickness absence and disability pension reduction.