Chronic Pain and Labour Market Affiliation: Effect of Demographic Factors and Comorbidities 5 Years Before and 2 Years After Multidisciplinary Treatment

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-09-26 DOI:10.1002/ejp.70135

Lea Stevnsborg, Magnus Pedersen, Lilli Kirkeskov, Per Føge Jensen, Merete Osler

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Abstract

Purpose

This study investigates the association of sociodemographic factors and comorbidities with labour market affiliation among patients with non-malignant chronic pain treated at multidisciplinary pain centres in Denmark.

Methods

This registry-based cohort study used data from the nationwide Danish Civil Registration System and Danish National Patient Registry. Patients treated at multidisciplinary pain centres in 2013–2017 were included. Labour market affiliation was assessed 5 years before and 2 years after treatment and at treatment initiation (baseline). Sequence and logistic regression analyses were used to identify associations.

Results

2375 patients (median age 47 years, female 64%, comorbidity: Mean Charlson's comorbidity score: 0.88, affective disorder: 45%, anxiety disorder: 37.0%, personality disorder: 7.8%) were included. At treatment initiation, only 34.2% of patients were employed, compared to 58.6% 5 years before treatment. Sequence analysis revealed that most patients remained in or transitioned to a ‘no labour market affiliation’ state. Factors significantly associated with labour market affiliation across timepoints included age (adjusted odd ratio [aOR] and 95% confidence interval [CI]_{age 56–65} = 0.51 [0.38–0.69]), marital status (aOR_cohabitant = 1.58 [1.30–1.92]), education level (aOR_high = 4.56 [3.51–5.93]), immigrant status (aOR_non-western = 0.35 [0.26–0.45]) and psychiatric comorbidities (aOR_{affective disorders} = 0.67 [0.56–0.87]).

Conclusion

Patients with high-impact, treatment-resistant chronic pain face early labour market detachment, highlighting the need for timely, equitable interventions to support employment, especially among vulnerable groups.

Significance Statement

The study offers new evidence on how socioeconomic and psychiatric comorbid vulnerabilities shape long-term labour market affiliation before relevant multidisciplinary treatment is initiated and suggests that key intervention opportunities for at-risk patients may be missed under current practice.

Abstract Image

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慢性疼痛和劳动力市场关联：多学科治疗前5年和后2年人口统计学因素和合并症的影响

目的：本研究调查在丹麦多学科疼痛中心接受治疗的非恶性慢性疼痛患者的社会人口因素和共病与劳动力市场关系的关系。方法：这项基于登记的队列研究使用了丹麦全国民事登记系统和丹麦国家患者登记处的数据。纳入2013-2017年在多学科疼痛中心治疗的患者。在治疗前5年、治疗后2年和治疗开始时（基线）评估劳动力市场联系。序列和逻辑回归分析用于确定关联。结果纳入2375例患者，中位年龄47岁，女性64%，共病：Charlson共病平均评分0.88分，情感性障碍：45%，焦虑性障碍：37.0%，人格障碍：7.8%。在治疗开始时，只有34.2%的患者受雇，而在治疗前5年，这一比例为58.6%。序列分析显示，大多数患者仍处于或过渡到“无劳动力市场关联”状态。跨时间点与劳动力市场关联显著相关的因素包括年龄（调整后的奇比[aOR]和95%可信区间[CI]：年龄56-65 = 0.51[0.38-0.69]）、婚姻状况（同居者= 1.58[1.30-1.92]）、教育水平（高居者= 4.56[3.51-5.93]）、移民身份（非西方者= 0.35[0.26-0.45]）和精神合并症（情感障碍= 0.67[0.56-0.87]）。结论高影响、难治性慢性疼痛患者面临早期劳动力市场脱离，需要及时、公平的干预措施来支持就业，尤其是弱势群体。该研究提供了新的证据，说明在相关的多学科治疗开始之前，社会经济和精神共病脆弱性如何影响长期的劳动力市场关系，并表明在目前的实践中，可能会错过高危患者的关键干预机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.