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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author 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
author_facet 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
author_sort Daniel Szczotkowski
collection DOAJ
description 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).
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series Pain and Therapy
spelling doaj-art-adeef628ed0b4b868b51f380d3d6c4112025-08-20T03:48:03ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2025-04-011431081110210.1007/s40122-025-00729-3Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in GermanyDaniel Szczotkowski0Sandra Meyer-Moock1Thomas Kohlmann2Karin Deppe3Anne Gärtner4Greta Hoffmann5Thomas Isenberg6Gabriele Lindena7Ursula Marschall8Carolin Martin9Beatrice Metz-Oster10Lena Milch11André Möller12Bernd Nagel13Frank Petzke14Anke Preissler15Julia Pritzke-Michael16Leonie Schouten17Katja Schwenk18Catharina Schumacher19Anja Waidner20Ulrike Kaiser21Institute for Community Medicine, Greifswald University Medicine, Section Methods in Community MedicineInstitute for Community Medicine, Greifswald University Medicine, Section Methods in Community MedicineInstitute for Community Medicine, Greifswald University Medicine, Section Methods in Community MedicineDepartment of Anaesthesiology, University Medical Centre GöttingenUniversity Pain Centre, University Hospital Carl Gustav Carus DresdenUniversity Pain Centre, University Hospital Carl Gustav Carus DresdenGerman Pain SocietyGerman Pain SocietyBARMERGerman Pain SocietyGerman Red Cross Pain Centre MainzGerman Red Cross Pain Centre MainzGerman Pain SocietyGerman Red Cross Pain Centre MainzDepartment of Anaesthesiology, University Medical Centre GöttingenUniversity Pain Centre, University Hospital Carl Gustav Carus DresdenUniversity Pain Centre, University Hospital Carl Gustav Carus DresdenDepartment of Anaesthesiology, University Medical Centre GöttingenGerman Red Cross Pain Centre MainzBARMERGerman Pain SocietyUniversity Pain Centre, University Hospital Carl Gustav Carus DresdenAbstract 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).https://doi.org/10.1007/s40122-025-00729-3Chronic painHealthcare deliveryMedical pain assessmentMixed models for repeated measuresMultimodal interdisciplinary pain treatmentPain and risk factors
spellingShingle 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
Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany
Pain and Therapy
Chronic pain
Healthcare delivery
Medical pain assessment
Mixed models for repeated measures
Multimodal interdisciplinary pain treatment
Pain and risk factors
title Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany
title_full Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany
title_fullStr Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany
title_full_unstemmed Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany
title_short Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany
title_sort evaluating an early interdisciplinary multimodal assessment for patients at risk of developing chronic pain results of a multicentre rct in germany
topic Chronic pain
Healthcare delivery
Medical pain assessment
Mixed models for repeated measures
Multimodal interdisciplinary pain treatment
Pain and risk factors
url https://doi.org/10.1007/s40122-025-00729-3
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