While interdisciplinary multimodal pain treatment (IMPT) is an effective treatment option for chronic low back pain, it is usually accomplished as an inpatient treatment incurring substantial healthcare costs. Day hospital IMPT could be a resource-saving alternative approach, but whether treatment setting is associated with differences in treatment outcomes has not yet been studied. In a retrospective matched cohort study including data from N = 595 patients diagnosed with chronic back pain and undergoing IMPT at the back pain center in Essen, Germany, we investigated the association between treatment setting (ie, inpatient or day patient of an otherwise identical IMPT) and pain intensity, disability, and self-efficacy after treatment. Outcomes were assessed by questionnaires used in clinical routine, collected at pre-IMPT, post-IMPT, and at 3-, 6-, and 12-month follow-up. The results indicate that day patients showed greater improvements in pain-related disability at 3-month post-IMPT (d = 0.74) and in pain intensity at 6-month post-IMPT (d = 0.79), compared to a matched sample of inpatients. Moreover, day patients achieved higher scores in pain-related self-efficacy at discharge, 3- and 6-month post-IMPT (d = 0.62, 0.99, and 1.21, respectively) and reported fewer incapacity-for-work days than inpatients at 6-month post-IMPT (d = 0.45). These data suggest that day hospital IMPT can be as effective as inpatient treatment and might even be more effective for the less afflicted patients. Further research regarding treatment setting and indication could guide optimized and cost-efficient treatments that are more closely tailored to the individual patient's needs.

中文翻译：

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为缓解疼痛奠定基础：治疗环境如何影响慢性背痛患者的跨学科多模式疼痛治疗。


虽然跨学科多模式疼痛治疗 （IMPT） 是治疗慢性腰痛的有效选择，但它通常是作为住院治疗完成的，会产生大量的医疗费用。日间医院 IMPT 可能是一种节省资源的替代方法，但尚未研究治疗环境是否与治疗结局的差异相关。在一项回顾性匹配队列研究中，包括来自 N = 595 名被诊断患有慢性背痛并在德国埃森背痛中心接受 IMPT 的患者的数据，我们调查了治疗环境（即其他方面相同的 IMPT 的住院或日间患者）与疼痛强度、残疾和治疗后自我效能之间的关联。通过临床常规中使用的问卷评估结果，在 IMPT 前、 IMPT 后以及 3 、 6 和 12 个月的随访中收集。结果表明，与匹配的住院患者样本相比，日间患者在 IMPT 后 3 个月 （d = 0.74） 和在 IMPT 后 6 个月 （d = 0.79） 的疼痛强度方面表现出更大的改善。此外，日间患者在出院时、IMPT 后 3 个月和 6 个月在疼痛相关自我效能感方面取得了更高的分数 （d = 0.62 、 0.99 和 1.21），并且在 IMPT 后 6 个月报告的无工作能力天数少于住院患者 （d = 0.45）。这些数据表明，日间医院 IMPT 可以与住院治疗一样有效，甚至可能对病情较轻的患者更有效。关于治疗设置和适应症的进一步研究可以指导更紧密地适应个体患者需求的优化和具有成本效益的治疗。