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Behavioural medicine, health and living habits

Implementation of a behavioural medicine approach in physiotherapy for treatment of persistent pain

The overall aim of the project is to develop and evaluate methods for supporting implementation of an evidence based behavioural medicine approach in physiotherapy for patients with persistent musculoskeletal pain.

Start

2015-09-01

Planned completion

2023-12-31

Main financing

AFA Insurance

Co-financing

MDH

Collaboration partners

Region Västmanland, Region Sörmland, Region Gävleborg, Högskolan i Dalarna.

Project manager at MDH

Professor

Anne Söderlund

+4621151708

anne.soderlund@mdh.se

One in five persons in Sweden suffer from persistent musculsoskeletal pain, which contributes to disability to participate in daily life activities and sick leave. The pain also contributes to a great economic burden for the individual and the society, especially because of indirect costs such as productivity loss. The development of persistent musculoskeletal pain is multifactorial and occurs through the interaction of biopsychosocial factors in the individual's life. Current research shows that a behavioural medicine approach in physiotherapy increases the ability to participate in daily activities and decreases sick leave in patients with persistent musculoskeletal pain. A behavioural medical approach means that the assessments and treatments are individually tailored targeting relevant biopsychosocial factors. Active patient involvement is central and behaviour change techniques are used to support the patient’s behaviour change. Most of these patients seek physiotherapy at primary health care level. Therefore, the behavioural medicine approach needs to be implemented in physiotherapy at primary health care level. However, implementation of new evidence based guidelines is challenging and there are no studies describing successful implementation interventions of a behavioural medicine approach in physiotherapy. There is therefore a need to study the implementation process and its effects, which can contribute to the dissemination of effective treatment methods for patients with persistent musculoskeletal pain. The overall aim of the project is therefore to develop and evaluate methods for supporting implementation of an evidence based behavioural medicine approach in physiotherapy for patients with persistent musculoskeletal pain.

Within the project, an implementation intervention has been developed based on identified determinants for using a behavioural medicine approach in physiotherapy (1). The implementation intervention has been tested and evaluated over time, focusing on changes in the physiotherapists’ clinical behaviours (2) and the effect on patients' health (3). A process evaluation has been carried out in order to explain the implementation intervention’s mechanisms of impact (4). What remains of the project are long-term follow-ups of patients' health.

  • Fritz, J., Söderbäck, M., Söderlund, A., & Sandborgh, M. (2018). The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice. Physiotherapy Theory and Practice. https://www.ncbi.nlm.nih.gov/pubmed/29847287external link
  • Fritz, J., Almqvist, L., Söderlund, A., Wallin, L., & Sandborgh, M. Implementation of a behavioural medicine approach in physiotherapy: impact on patient outcomes.