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Predictors of Sickness Absence in a Clinical Population With Chronic Pain
Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; School of Health and Welfare, Dalarna University, Falun, Sweden.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.ORCID iD: 0000-0002-3955-0443
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.ORCID iD: 0000-0002-1607-187X
School of Health and Welfare, Dalarna University, Falun, Sweden.
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2021 (English)In: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, Vol. 22, no 10, p. 1180-1194Article in journal (Refereed) Published
Abstract [en]

Chronic pain-related sickness absence is an enormous socioeconomic burden globally. Optimized interventions are reliant on a lucid understanding of the distribution of social insurance benefits and their predictors. This register-based observational study analyzed data for a 7-year period from a population-based sample of 44,241 chronic pain patients eligible for interdisciplinary treatment (IDT) at specialist clinics. Sequence analysis was used to describe the sickness absence over the complete period and to separate the patients into subgroups based on their social insurance benefits over the final 2 years. The predictive performance of features from various domains was then explored with machine learning-based modeling in a nested cross-validation procedure. Our results showed that patients on sickness absence increased from 17% 5 years before to 48% at the time of the IDT assessment, and then decreased to 38% at the end of follow-up. Patients were divided into 3 classes characterized by low sickness absence, sick leave, and disability pension, with eight predictors of class membership being identified. Sickness absence history was the strongest predictor of future sickness absence, while other predictors included a 2008 policy, age, confidence in recovery, and geographical location. Information on these features could guide personalized intervention in the specialized healthcare. PERSPECTIVE: This study describes sickness absence in patients who visited a Swedish pain specialist interdisciplinary treatment clinic during the period 2005 to 2016. Predictors of future sickness absence are also identified that should be considered when adapting IDT programs to the patient's needs.

Place, publisher, year, edition, pages
Philadelphia, PA, United States: Churchill Livingstone , 2021. Vol. 22, no 10, p. 1180-1194
Keywords [en]
Chronic pain, epidemiology, machine learning, productivity loss, sickness absence
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:liu:diva-177214DOI: 10.1016/j.jpain.2021.03.145ISI: 000705022800004PubMedID: 33819574Scopus ID: 2-s2.0-85105356711OAI: oai:DiVA.org:liu-177214DiVA, id: diva2:1571644
Note

Funding: Swedish Research Council (Vetenskapsradet)Swedish Research Council [2015-02512]; Swedish Research Council for Health Working Life & Welfare (Forte) [FORTE: 2016-07414, 2017-00177]

Available from: 2021-06-22 Created: 2021-06-22 Last updated: 2025-02-20Bibliographically approved

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Dahlström, ÖrjanBjörk, MathildaGerdle, Björn

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