The Individual Placement and Support (IPS) in Pain Trial: A Randomized Controlled Trial of IPS for Patients with Chronic Pain Conditions

Vigdis Sveinsdottir, Henrik Børsting Jacobsen, Tone Marte Ljosaa, Lene Therese Bergerud Linnemørken, Thomas Knutzen, Reza Ghiasvand, Silje Endresen Reme, Vigdis Sveinsdottir, Henrik Børsting Jacobsen, Tone Marte Ljosaa, Lene Therese Bergerud Linnemørken, Thomas Knutzen, Reza Ghiasvand, Silje Endresen Reme

Abstract

Objectives: Although complex pain conditions require an interdisciplinary approach, employment services are rarely provided in pain centers. Individual Placement and Support (IPS) is an effective approach to increase work participation among patients with severe mental illness, and recent evidence suggests that this method can be successfully repurposed for new target groups. We aimed to investigate the effectiveness of IPS integrated with interdisciplinary treatment as usual (TAU) for patients with chronic pain in a tertiary pain center.

Methods: A randomized controlled trial comparing IPS integrated with TAU (n = 38) with TAU alone (n = 20) was conducted. Participants were patients with chronic pain who were 18-65 years of age and currently on long-term sick leave or disability benefits or unemployed. The primary outcome was employment within 12 months after enrollment, with additional long-term follow-up after 24 months. Secondary outcomes included health and quality of life, measured at baseline, 6 months, and 12 months.

Results: During 12-month follow-up, 52.8% in the IPS group and 38.9% in the TAU group had attained employment. The difference increased during 24-month follow-up but did not reach statistical significance. Findings on secondary outcomes were generally nonsignificant.

Conclusions: The IPS in Pain trial is the first study to evaluate the effect of IPS for patients with chronic pain conditions. It shows that IPS can be integrated into the daily practice of interdisciplinary pain treatment, with employment rates exceeding 50% in 1 year and a clear trend in favor of the IPS group. Results did not, however, reach significance. Larger randomized controlled trials are needed to draw clear conclusions about effectiveness.

Trial registration: ClinicalTrials.gov NCT02697656.

Keywords: Chronic Pain; Individual Placement and Support; Integrated Care; Randomized Controlled Trial; Work Disability.

© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

Figures

Figure 1.
Figure 1.
Participant flow.
Figure 2.
Figure 2.
Employment rates in each group during 6-, 12-, and 24-month follow-up.

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Source: PubMed

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