First trans-diagnostic experiences with a novel micro-choice based concentrated group rehabilitation for patients with low back pain, long COVID, and type 2 diabetes: a pilot study.
Anxiety
Chronic illness
Concentrated rehabilitation
Depression
Fatigue
Long COVID
Low back pain
Micro-choice
Post COVID-19 condition
Post-COVID-19 symptoms
Type 2 Diabetes
Journal
BMC medicine
ISSN: 1741-7015
Titre abrégé: BMC Med
Pays: England
ID NLM: 101190723
Informations de publication
Date de publication:
11 Jan 2024
11 Jan 2024
Historique:
received:
16
05
2023
accepted:
19
12
2023
medline:
11
1
2024
pubmed:
11
1
2024
entrez:
10
1
2024
Statut:
epublish
Résumé
The health care is likely to break down unless we are able to increase the level of functioning for the growing number of patients with complex, chronic illnesses. Hence, novel high-capacity and cost-effective treatments with trans-diagnostic effects are warranted. In accordance with the protocol paper, we aimed to examine the acceptability, satisfaction, and effectiveness of an interdisciplinary micro-choice based concentrated group rehabilitation for patients with chronic low back pain, long COVID, and type 2 diabetes. Patients with low back pain > 4 months sick-leave, long COVID, or type 2 diabetes were included in this clinical trial with pre-post design and 3-month follow-up. The treatment consisted of three phases: (1) preparing for change, (2) the concentrated intervention for 3-4 days, and (3) integrating change into everyday life. Patients were taught and practiced how to monitor and target seemingly insignificant everyday micro-choices, in order to break the patterns where symptoms or habits contributed to decreased levels of functioning or increased health problems. The treatment was delivered to groups (max 10 people) with similar illnesses. Client Satisfaction Questionnaire (CSQ-8)) (1 week), Work and Social Adjustment Scale (WSAS), Brief Illness Perception Questionnaire (BIPQ), and self-rated health status (EQ-5D-5L) were registered at baseline and 3-month follow-up. Of the 241 included participants (57% women, mean age 48 years, range 19-84), 99% completed the concentrated treatment. Treatment satisfaction was high with a 28.9 (3.2) mean CSQ-8-score. WSAS improved significantly from baseline to follow-up across diagnoses 20.59 (0.56) to 15.76 (0.56). BIPQ improved from: 22.30 (0.43) to 14.88 (0.47) and EQ-5D-5L: 0.715 (0.01) to 0.779 (0.01)), all P<0.001. Across disorders, the novel approach was associated with high acceptability and clinically important improvements in functional levels, illness perception, and health status. As the concentrated micro-choice based treatment format might have the potential to change the way we deliver rehabilitation across diagnoses, we suggest to proceed with a controlled trial. ClinicalTrials.gov NCT05234281.
Sections du résumé
BACKGROUND
BACKGROUND
The health care is likely to break down unless we are able to increase the level of functioning for the growing number of patients with complex, chronic illnesses. Hence, novel high-capacity and cost-effective treatments with trans-diagnostic effects are warranted. In accordance with the protocol paper, we aimed to examine the acceptability, satisfaction, and effectiveness of an interdisciplinary micro-choice based concentrated group rehabilitation for patients with chronic low back pain, long COVID, and type 2 diabetes.
METHODS
METHODS
Patients with low back pain > 4 months sick-leave, long COVID, or type 2 diabetes were included in this clinical trial with pre-post design and 3-month follow-up. The treatment consisted of three phases: (1) preparing for change, (2) the concentrated intervention for 3-4 days, and (3) integrating change into everyday life. Patients were taught and practiced how to monitor and target seemingly insignificant everyday micro-choices, in order to break the patterns where symptoms or habits contributed to decreased levels of functioning or increased health problems. The treatment was delivered to groups (max 10 people) with similar illnesses. Client Satisfaction Questionnaire (CSQ-8)) (1 week), Work and Social Adjustment Scale (WSAS), Brief Illness Perception Questionnaire (BIPQ), and self-rated health status (EQ-5D-5L) were registered at baseline and 3-month follow-up.
RESULTS
RESULTS
Of the 241 included participants (57% women, mean age 48 years, range 19-84), 99% completed the concentrated treatment. Treatment satisfaction was high with a 28.9 (3.2) mean CSQ-8-score. WSAS improved significantly from baseline to follow-up across diagnoses 20.59 (0.56) to 15.76 (0.56). BIPQ improved from: 22.30 (0.43) to 14.88 (0.47) and EQ-5D-5L: 0.715 (0.01) to 0.779 (0.01)), all P<0.001.
CONCLUSIONS
CONCLUSIONS
Across disorders, the novel approach was associated with high acceptability and clinically important improvements in functional levels, illness perception, and health status. As the concentrated micro-choice based treatment format might have the potential to change the way we deliver rehabilitation across diagnoses, we suggest to proceed with a controlled trial.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov NCT05234281.
Identifiants
pubmed: 38200486
doi: 10.1186/s12916-023-03237-3
pii: 10.1186/s12916-023-03237-3
doi:
Banques de données
ClinicalTrials.gov
['NCT05234281']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
12Subventions
Organisme : EkstraStiftelsen Helse og Rehabilitering (Stiftelsen Dam)
ID : 389457
Organisme : EkstraStiftelsen Helse og Rehabilitering (Stiftelsen Dam)
ID : 389461
Informations de copyright
© 2023. The Author(s).
Références
WHO Noncommunicable diseases. https://www.who.int/health-topics/noncommunicable-diseases#tab=tab_1 .
Akseer N, Mehta S, Wigle J, Chera R, Brickman ZJ, Al-Gashm S, et al. Non-communicable diseases among adolescents: current status, determinants, interventions and policies. BMC Public Health. 2020;20:1–20.
doi: 10.1186/s12889-020-09988-5
Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CWC, Chenot JF, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018;27:2791–803.
doi: 10.1007/s00586-018-5673-2
pubmed: 29971708
WHO. Rehabilitation and COVID-19. https://www.who.int/teams/noncommunicable-diseases/covid-19/rehabilitation .
Care D, Suppl SS. 5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes—2022. Diabetes Care. 2022;45 January:S60–82.
Carver CS, Scheier MF. Situational coping and coping dispositions in a stressful transaction. J Pers Soc Psychol. 1994;66:184–95.
doi: 10.1037/0022-3514.66.1.184
pubmed: 8126648
Van den Bergh O, Witthöft M, Petersen S, Brown RJ. Symptoms and the body: taking the inferential leap. Neurosci Biobehav Rev. 2017;74:185–203.
doi: 10.1016/j.neubiorev.2017.01.015
pubmed: 28108416
Kvale G, Frisk B, Jürgensen M, Børtveit T, Ødegaard-Olsen ØT, Wilhelmsen-Langeland A, et al. Evaluation of novel concentrated interdisciplinary group rehabilitation for patients with chronic illnesses: Protocol for a nonrandomized clinical intervention study. JMIR Res Protoc. 2021;10(10):e32216.
doi: 10.2196/32216
pubmed: 34505838
pmcid: 8500350
Frisk B, Njøten KL, Aarli B, Hystad SW, Rykken S, Kjosås A, et al. A Novel concentrated, interdisciplinary group rehabilitation program for patients with chronic obstructive pulmonary disease: protocol for a nonrandomized clinical intervention study. JMIR Res Protoc. 2022;11:e40700.
doi: 10.2196/40700
pubmed: 36287602
pmcid: 9647463
Kvale G, Langeland AW, Jürgensen M, Hystad SW, Öst LG. Concentrated transdiagnostic and cross ‑ disciplinary group treatment for patients with depression and with anxiety : a pilot study. BMC Psychiatry. 2022;:1–11.
NAV. Sick leave and disability statistics. 2023. https://www.nav.no/no/nav-og-samfunn/statistikk/sykefravar-statistikk/sykefravar .
Hansen B, Hagen K, Öst L-G, Solem S, Kvale G. The Bergen 4-day OCD treatment delivered in a group setting: 12-month follow-up. Front Psychol. 2018;9:639.
doi: 10.3389/fpsyg.2018.00639
pubmed: 29774005
pmcid: 5943612
Stubhaug B, Lier HO, Aßmus J, Rongve A, Kvale G. A 4-Day mindfulness-based cognitive behavioral intervention program for CFS/ME. an open study, with 1-year follow-up. Front Psychiatry. 2018;9:720.
doi: 10.3389/fpsyt.2018.00720
pubmed: 30618889
pmcid: 6306445
Hansen B, Kvale G, Hagen K, Havnen A, Öst L-G. The Bergen 4-day treatment for OCD: four years follow-up of concentrated ERP in a clinical mental health setting. Cogn Behav Ther. 2019;48:89–105.
doi: 10.1080/16506073.2018.1478447
pubmed: 30088441
Kvale G, Hansen B, Björgvinsson T, Børtveit T, Hagen K, Haseth S, et al. Successfully treating 90 patients with obsessive compulsive disorder in eight days: the Bergen 4-day treatment. BMC Psychiatry. 2018;18:323.
doi: 10.1186/s12888-018-1887-4
pubmed: 30286745
pmcid: 6172736
Launes G, Hagen K, Sunde T, Öst L-G, Klovning I, Laukvik I-L, et al. A Randomized Controlled Trial of Concentrated ERP, Self-Help and Waiting List for Obsessive- Compulsive Disorder: The Bergen 4-Day Treatment. Front Psychol. 2019;10:2500.
doi: 10.3389/fpsyg.2019.02500
pubmed: 31803089
pmcid: 6873786
Helse i Hardanger (introduction film).2021. https://www.youtube.com/watch?v=qHW0IIlW_QM&t=124s
Nguyen TD, Attkisson CC, Stegner BL. Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire. Eval Program Plann. 1983;6(3–4):299–313.
doi: 10.1016/0149-7189(83)90010-1
pubmed: 10267258
Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60:631–7.
doi: 10.1016/j.jpsychores.2005.10.020
pubmed: 16731240
Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the brief illness perception questionnaire. Psychol Heal. 2015;30:1361–85.
doi: 10.1080/08870446.2015.1070851
Mundt JC, Marks IM, Shear MK, Greist JH. The work and social adjustment scale: a simple measure of impairment in functioning. Br J Psychiatry. 2002;180:461–4.
doi: 10.1192/bjp.180.5.461
pubmed: 11983645
Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20:1727–36.
doi: 10.1007/s11136-011-9903-x
pubmed: 21479777
pmcid: 3220807
Devlin N, Roudijk B, Ludwig K, editors. Value Sets for EQ-5D-5L. Cham: Springer International Publishing; 2022.
Garratt AM, Hansen TM, Augestad LA, Rand K, Stavem K. Norwegian population norms for the EQ-5D-5L: results from a general population survey. Qual Life Res. 2022;31:517–26.
doi: 10.1007/s11136-021-02938-7
pubmed: 34272631
Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863.
doi: 10.3389/fpsyg.2013.00863
pubmed: 24324449
pmcid: 3840331
Frisk B, Jürgensen M, Espehaug B, Njøten KL, Søfteland E, Aarli BB, et al. OPEN A safe and effective micro ‑ choice based rehabilitation for patients with long COVID : results from a quasi ‑ experimental study. Sci Rep. 2023;:1–10.
Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 2023;21:133–46.
doi: 10.1038/s41579-022-00846-2
pubmed: 36639608
pmcid: 9839201
Garratt AM, Furunes H, Hellum C, Solberg T, Brox JI, Storheim K, et al. Evaluation of the EQ-5D-3L and 5L versions in low back pain patients. Health Qual Life Outcomes. 2021;19:1–9.
doi: 10.1186/s12955-021-01792-y
Ryum T, Stiles TC. Changes in pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy mediate changes in pain intensity on disability in the treatment of chronic low back pain. PAIN Reports. 2023;8: e1092.
doi: 10.1097/PR9.0000000000001092
pubmed: 37719924
pmcid: 10501475
Godfrey E, Wileman V, Galea Holmes M, McCracken LM, Norton S, Moss-Morris R, et al. Physical therapy informed by acceptance and commitment therapy (PACT) versus usual care physical therapy for adults with chronic low back pain: a randomized controlled trial. J Pain. 2020;21:71–81.
doi: 10.1016/j.jpain.2019.05.012
pubmed: 31173921
Hansen B, Kvale G, Hagen K, Hjelle KM, Solem S, Bø B, et al. The Bergen 4-day treatment for panic disorder: a pilot study. Front Psychol. 2018;9:1044.
Vibe Fersum K, O’Sullivan P, Skouen JS, Smith A, Kvåle A. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur J Pain. 2013;17:916–28.
doi: 10.1002/j.1532-2149.2012.00252.x
pubmed: 23208945
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391:2356–67.
doi: 10.1016/S0140-6736(18)30480-X
pubmed: 29573870
Blomberg B, Mohn KGI, Brokstad KA, Zhou F, Linchausen DW, Hansen BA, et al. Long COVID in a prospective cohort of home-isolated patients. Nat Med. 2021;27:1607–13.
doi: 10.1038/s41591-021-01433-3
pubmed: 34163090
pmcid: 8440190
Shamshirgaran SM, Stephens C, Alpass F, Aminisani N. Longitudinal assessment of the health-related quality of life among older people with diabetes: results of a nationwide study in New Zealand. BMC Endocr Disord. 2020;20:1–9.
doi: 10.1186/s12902-020-0519-4