Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany

Abstract Introduction Patients at risk of developing chronic pain are often significantly impaired in their daily, social and work activities. An early interdisciplinary multimodal assessment (IMA) includes a systematically integrated view of medical, psychosocial and functional factors to direct pa...

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Main Authors: Daniel Szczotkowski, Sandra Meyer-Moock, Thomas Kohlmann, Karin Deppe, Anne Gärtner, Greta Hoffmann, Thomas Isenberg, Gabriele Lindena, Ursula Marschall, Carolin Martin, Beatrice Metz-Oster, Lena Milch, André Möller, Bernd Nagel, Frank Petzke, Anke Preissler, Julia Pritzke-Michael, Leonie Schouten, Katja Schwenk, Catharina Schumacher, Anja Waidner, Ulrike Kaiser
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-04-01
Series:Pain and Therapy
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Online Access:https://doi.org/10.1007/s40122-025-00729-3
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Summary:Abstract Introduction Patients at risk of developing chronic pain are often significantly impaired in their daily, social and work activities. An early interdisciplinary multimodal assessment (IMA) includes a systematically integrated view of medical, psychosocial and functional factors to direct patients to need-based treatment services. This multicentre, randomised, controlled trial examined the effects of an IMA on preventing chronic pain and improving care for adult patients. Methods The intervention group (IG) received an IMA in accordance with standardised guidelines. The control group (CG) was offered a unimodal medical pain assessment (MPA). Data from the Characteristic Pain Intensity (PI) and Disability Score (DS), as primary outcomes, were collected at assessment and 3 and 6 months later together with secondary outcomes (e.g. depression, anxiety, stress, catastrophizing, health-related quality of life). Results A total of 620 (68.4%) valid questionnaires were available at the 6-month follow-up. The mean reduction (numerical rating scale, 0–10) in terms of improvement within both groups (IG/CG) was 1.6/1.7 points for PI and 1.9/1.8 points for DS. Most secondary outcomes improved as well. However, the differences between the two groups did not reach statistical significance, although there was a tendency for the IG to have a greater effect on some psychological outcomes. Regarding the recommended treatment approaches, the focus in the IG was more on physical activity and psychological and psychosomatic interventions, whereas in the CG there was also a preference for adjusting the medication. Conclusions Both early MPA and IMA seem to have a positive effect on outcomes such as pain intensity, functional limitations and psychological factors for patients at risk of developing chronic pain. We critically reflect on the results of the primary research question by discussing the limitations in detail and conclude that further research should ensure that the control conditions reflect standard care and that the follow-up period is long enough. Trial registration German Clinical Trials Register (DRKS-ID: DRKS00015443).
ISSN:2193-8237
2193-651X