疼痛中的个体放置和支持(IPS)试验:一项针对慢性疼痛患者的随机对照试验

Vigdis Sveinsdottir, H. B. Jacobsen, T. M. Ljosaa, L. T. B. Linnemørken, Thomas Knutzen, R. Ghiasvand, S. Reme
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引用次数: 2

摘要

虽然复杂的疼痛条件需要跨学科的方法,就业服务很少在疼痛中心提供。个体安置和支持(IPS)是提高严重精神疾病患者工作参与度的有效方法,最近的证据表明,这种方法可以成功地用于新的目标群体。我们的目的是研究IPS结合跨学科治疗(TAU)对三级疼痛中心慢性疼痛患者的有效性。方法采用随机对照试验,将IPS联合TAU (n = 38)与TAU单独(n = 20)进行比较。参与者是18-65岁的慢性疼痛患者,目前正在长期病假或残疾福利或失业。主要结果是入组后12个月内的就业,24个月后进行额外的长期随访。次要结局包括健康和生活质量,在基线、6个月和12个月时测量。结果随访12个月,IPS组和TAU组分别有52.8%和38.9%的患者就业。随访24个月,差异有所增加,但无统计学意义。次要结局的发现一般不显著。结论IPS in Pain试验是首个评估IPS对慢性疼痛患者疗效的研究。这表明IPS可以融入跨学科疼痛治疗的日常实践,1年内就业率超过50%,IPS组有明显的优势趋势。然而,结果并没有达到显著性。需要更大规模的随机对照试验来得出关于有效性的明确结论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Individual Placement and Support (IPS) in Pain Trial: A Randomized Controlled Trial of IPS for Patients with Chronic Pain Conditions
Abstract Objectives Although complex pain conditions require an interdisciplinary approach, employment services are rarely provided in pain centers. Individual Placement and Support (IPS) is an effective approach to increase work participation among patients with severe mental illness, and recent evidence suggests that this method can be successfully repurposed for new target groups. We aimed to investigate the effectiveness of IPS integrated with interdisciplinary treatment as usual (TAU) for patients with chronic pain in a tertiary pain center. Methods A randomized controlled trial comparing IPS integrated with TAU (n = 38) with TAU alone (n = 20) was conducted. Participants were patients with chronic pain who were 18–65 years of age and currently on long-term sick leave or disability benefits or unemployed. The primary outcome was employment within 12 months after enrollment, with additional long-term follow-up after 24 months. Secondary outcomes included health and quality of life, measured at baseline, 6 months, and 12 months. Results During 12-month follow-up, 52.8% in the IPS group and 38.9% in the TAU group had attained employment. The difference increased during 24-month follow-up but did not reach statistical significance. Findings on secondary outcomes were generally nonsignificant. Conclusions The IPS in Pain trial is the first study to evaluate the effect of IPS for patients with chronic pain conditions. It shows that IPS can be integrated into the daily practice of interdisciplinary pain treatment, with employment rates exceeding 50% in 1 year and a clear trend in favor of the IPS group. Results did not, however, reach significance. Larger randomized controlled trials are needed to draw clear conclusions about effectiveness.
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