Matching Interventions to Risks: Implementing Early Interventions to Prevent Disability due to chronic Pain

Sick leave, suffering,  and disability due to musculoskeletal pain continues to be a major problem.  Research has identified risk factors and it is now possible to identify patients who risk long-term problems. The evidence also shows that early interventions e.g. activity training or various forms of cognitive behavioral treatments reduce symptoms and help to prevent disability. To date however, there is no system for matching interventions to the risk factors identified. Indeed, a recent review shows an incredible lack of a match between known risk factors and intervention strategies.

This application offers a fresh approach for clearly matching the intervention to specific risk profiles.  It is based on existing assessment procedures where a profile of the patients risk items can be made. This profile in turn provides a basis for matching an evidence-based intervention to the patient. Our hypothesis is that matching will improve utility. 

The goals of the present study are to:
•        Develop a system for assessing patients and providing an evidence based risk profile that enhances a matching of the intervention to the profile. With a focus on workers we will develop the program in cooperation with health care services and workplaces.
•        Evaluate the effects of matching the treatment to the risk profile
•        Evaluate the relative effects of three pertinent interventions on outcome

 To reach these goals we will:
• Work with health services and workplaces to recruit patients
• test the accuracy and usefulness of the assessment and profile system
• develop further the system for matching intervention to the risk profile
• conduct a randomized controlled trial comparing effectiveness. Our unique design allows for directly assessing the effects of matching. It also provides information about the individual interventions, and the processes of treatment change.

In the end, this study will provide:
• an answer: does matching the  intervention to risk factors increases utility?
• knowledge of the effectiveness and feasibility of early detection and profiling
• knowledge about the relative effectiveness of pertinent interventions
• knowledge about the process of change in treatment
• intervention for more than 150 people risking chronic disability
• new insights into  a manageable method for preventing chronic disability in Sweden