AB1213 EFFECTIVENESS OF A ONE-WEEK INPATIENT MULTIMODAL PAIN TREATMENT PROGRAM FOR PATIENTS WITH RHEUMATOLOGIC DISEASES AND MUSCULOSKELETAL PAIN – A SINGLE CENTER OBSERVATIONAL STUDY

Abstract

BackgroundMultimodal rheumatologic complex treatment (MRCT) is a treatment concept for patients with rheumatologic diseases requiring acute inpatient care suffering from exacerbated pain and/or functional impairment. A rheumatologist directs the treatment program including multimodal assessments and treatment from three of the following: ergotherapy, physiotherapy, pain medicine and cognitive behavioural treatment. Most studies evaluated data from a two-week inpatient MRCT program.1 Available data on the effectiveness of a one-week inpatient multimodal treatment program are scarce. However, whether a shorter program might also be effective has not been studied so far.ObjectivesTo evaluate the effectiveness of a one-week inpatient multimodal and interprofessional treatment program on musculoskeletal pain and function of patients with rheumatologic disorders.Methods59 consecutive patients were entered into a program of multimodal treatment courses (MRCT) from January 2021 until December 2021. All patients completed a total of 11 hours of therapy in one week. Two patients were excluded for evaluation (one patient acquired COVID 19 during hospitalization and one patient was excluded due to missing data).Pain was assessed via visual analogue scale (VAS) and functional impairment via the “Funktionsfragebogen Hanover (FFbH)” and the “Health Assessment Questionnaire (HAQ)” at admission, at discharge and at 12 weeks of follow up. Paired t-test analyses for all treatment episodes were performed.ResultsThe mean treatment duration (days, ±SD) was 8.1 ± 0.8. Mean age (years, ±SD) of the 57 patients treated in the MRCT program was 57.2 ± 12.5, with 72% female and 28% male patients. Of all patients, 40% had an underlying inflammatory disorder, 60% a non - inflammatory rheumatic disease. 23% of all patients had “back pain”, 14% “spondyloarthritis” and 11% “rheumatoid arthritis”. Overall, VAS (pain) mean at admission was 6.9 ± 1.0 (SD), HAQ mean 0.57 ± 0.23 (SD) and FFbH mean 81.44 ± 7.95 (SD), respectively. Significant improvements in VAS, HAQ and FFbH were demonstrated at discharge (day 8), with a mean improvement of VAS of -2.86 (95% CI: -3.07 to -2.64, P value: <0.0001), a mean improvement of HAQ of -0.24 (95% CI: -0.28 to -0.20, P value: <0.0001) and a mean improvement of FFbH of 5.38 (95% CI: 3.78 to 6.98, P value: <0.0001). Follow up assessment at week 12 was recorded in 22 patients (39%) with a significant mean improvement in VAS of -2.23 (95% CI: -2.98 to -1.48), P value < 0.0001) (Table 1 and Figure 1).Figure 1.Table 1.VAS mean difference admission/discharge-2.86 (95% CI: -3.07 to -2.64, P value: <0.0001), n= 55HAQ mean difference admission/discharge-0.24 (95% CI: -0.28 to -0.20, P value: <0.0001), n= 57FFbH mean difference admission/discharge5.38 (95% CI: 3.78 to 6.98, P value: <0.0001), n= 56VAS mean difference admission/12 weeks follow up-2.23 (95% CI: -2.98 to -1.48, P value: <0.0001), n= 22HAQ mean difference admission/ 12 weeks follow up-0.16 (95% CI: -0.29 to -0.04, P value: 0.01), n= 22FFbH mean difference admission/12 weeks follow up3.96 (95% CI: 1.18 to 6.74, P value: 0.01), n= 22ConclusionSignificant improvement of pain and function was demonstrated at discharge and at week 12 in patients with rheumatologic diseases and musculoskeletal pain completing a one-week inpatient multimodal interprofessional treatment program. A multimodal therapeutic approach may provide an effective treatment strategy superior to unimodal standard management.References[1]Klemm P, Hudowenz O, Asendorf T, Müller-Ladner U, Lange U, Tarner IH. Multimodale rheumatologische Komplexbehandlung bei rheumatoider Arthritis – eine monozentrische Retrospektivanalyse [Multimodal rheumatologic complex treatment of rheumatoid arthritis-a monocentric retrospective analysis]. Z Rheumatol. 2019 Mar;78(2):136-142. German. doi: 10.1007/s00393-019-0593-z. PMID: 30715601.Disclosure of InterestsNone declared