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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005628naa a2200493 4500
001oai:DiVA.org:hh-25099
003SwePub
008140416s2013 | |||||||||||000 ||eng|
009oai:DiVA.org:uu-221192
009oai:DiVA.org:uu-221202
009oai:prod.swepub.kib.ki.se:128327660
009oai:prod.swepub.kib.ki.se:128324929
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-250992 URI
0247 a https://doi.org/10.1136/annrheumdis-2013-eular.4052 DOI
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2211922 URI
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2212022 URI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1283276602 URI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:1283249292 URI
040 a (SwePub)hhd (SwePub)uud (SwePub)uud (SwePub)kid (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Åsenlöf, Pernillau Uppsala universitet,Fysioterapi,Uppsala University, Uppsala, Sweden4 aut0 (Swepub:uu)pernasen
2451 0a Step-Up :b An Innovative Stepped-Care Protocol for Tailored Behavioral Medicine Treatment in the Management of Musculoskeletal Pain in Primary Care
264 c 2014-01-23
264 1a London :b BMJ Books,c 2013
338 a print2 rdacarrier
520 a Background: Multimodal rehabilitation and tailored behavioral medicine treatments should be provided to patients suffering from persistent and activity limiting pain according to current state-of-science. There is also evidence that a minimal intervention including 'stay-active advice' can produce effects comparable to effects of comprehensive treatment packages. Nevertheless, there is a gap of knowledge regarding which individuals who benefit the most from which modalities of pain treatment, at what time point, and with the highest cost-effectiveness. Accordingly, we have set up an innovative stepped-care protocol for the management of musculoskeletal pain in primary care, which is evaluated in a randomized controlled trial.Objectives: The aim is to compare effects and cost-effectiveness of a stepped care model including advice and tailored behavioral medicine pain treatment (experimental condition) with a stepped care model including advice and physical exercises (comparison condition) for patients with low back and neck pain and/or widespread pain including fibromyalgia in primary care. A further aim is to characterize patients who benefit/do not benefit from the respective steps i.e. treatments varying in dose and content.Methods: A stratified randomized stepped care design is applied. Stratification is based on primary care center and psychological risk profile. A consecutive selection is performed at primary care centers in southern, central and northern Sweden. After having received a minimal intervention (step 1) comprising 'stay-active advice', participants scoring high on the Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) according to preset criteria are randomly allocated to an eight-week treatment in step 2. The experimental condition includes supervised physical exercises integrated with either (a) graded activity, or (b) hierarchical graded exposure depending on psychological risk profile. The comparison condition includes supervised physical exercises irrespective of risk profile. Primary outcome is pain-related disability complemented with a comprehensive set of secondary outcomes adhering to the IMMPACT recommendations.Results: The stepped-care design will be presented including illustrations of conclusions possible to draw with this kind of innovative design.Conclusions: There is a call for stepped-care interventions within pain intervention research, particularly in the primary care setting. However, published studies are still lacking. This study will contribute to an important progression of behavioral medicine pain treatments by the way treatments are tailored in accordance with psychological risk profile. This will be discussed to stimulate research activities and collaboration within this area of research and clinical implementation.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
7001 a Demmelmaier, Ingridu Uppsala universitet,Fysioterapi,Uppsala University, Uppsala, Sweden4 aut0 (Swepub:uu)indem086
7001 a Emilson, Christinau Uppsala universitet,Fysioterapi,Uppsala University, Uppsala, Sweden4 aut0 (Swepub:uu)chrem483
7001 a Pettersson, Susanneu Karolinska Institutet4 aut
7001 a Bergman, Stefan,d 1959-u Spenshult Centre for Rheumatic Disease, Oskarström, Sweden4 aut0 (Swepub:hh)steber
7001 a Pettersson, Stefanu Uppsala universitet,Fysioterapi4 aut0 (Swepub:uu)stepe552
7102 a Uppsala universitetb Fysioterapi4 org
7730 t Annals of the Rheumatic Diseasesd London : BMJ Booksg 72:Suppl. 3, s. A120-A120q 72:Suppl. 3<A120-A120x 0003-4967x 1468-2060
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-25099
8564 8u https://doi.org/10.1136/annrheumdis-2013-eular.405
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-221192
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-221202
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:128327660
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:128324929

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