EVA-VMO: Evaluation of behavioural medicine-oriented rehabilitation for patients with musculoskeletal disorders

Mental comorbidity is a risk factor for the chronicity of back pain and is associated with an increased risk of receiving a disability pension. In Germany, medical rehabilitation programs focus on improving and restoring work ability. In case of mental comorbidity early identification and treatment of mental impairments are necessary to achieve these aims. BMR programs therefore follow a multidisciplinary and behavioral approach and integrate psychological single and group interventions. Controlled and randomized controlled trials have compared BMR programs and conventional medical rehabilitation programs and have shown effects on depression, pain-related coping strategies, pain and the self-reported health (efficacy). However, it is unclear if BMR also yields better results than conventional medical rehabilitation under real-life conditions (effectiveness) and if BMR is implemented as intended. We include patients with approved medical rehabilitation due to musculoskeletal disorders. Data are assessed by questionnaires before rehabilitation and 3 and 10 months after rehabilitation. Additionally, administrative data from the GPI accounts is used. Effectiveness of BMR will be tested by a propensity score matched comparison of BMR and medical rehabilitation patients. Additionally, individual and institutional moderators on effectiveness will be examined.