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. 2017 Jul 14;18(1):22.
doi: 10.1186/s12889-017-4588-x.

Rehabilitation access and effectiveness for persons with back pain: the protocol of a cohort study (REHAB-BP, DRKS00011554)

Matthias Bethge  1 , Kerstin Mattukat  2 , David Fauser  3 , Wilfried Mau  2
Affiliations

Rehabilitation access and effectiveness for persons with back pain: the protocol of a cohort study (REHAB-BP, DRKS00011554)

Matthias Bethge et al. BMC Public Health. .

Erratum in

  • Erratum to: BMC Public Health, Vol. 18.
    [No authors listed] [No authors listed] BMC Public Health. 2017 Sep 22;17(1):736. doi: 10.1186/s12889-017-4709-6. BMC Public Health. 2017. PMID: 28938882 Free PMC article. No abstract available.

Abstract

Background: Back pain is one of the most common chronic diseases in Germany and has a major impact on work ability and social participation. The German Pension Insurance (GPI) is the main provider of medical rehabilitation to improve work ability and prevent disability pensions in Germany. However, over half of the persons granted a disability pension have never used a medical rehabilitation service. Furthermore, evidence on the effects of medical rehabilitation in Germany is inconclusive. Consequently, this study has two aims: first, to determine barriers to using rehabilitation services, and second, to examine the effectiveness of medical rehabilitation in German residents with chronic back pain.

Methods: In 2017 a postal questionnaire will be sent to 45,000 persons aged 45 to 59 years whose pension insurance contributions are managed by the GPI North or the GPI Central Germany. In 2019 respondents who report back pain in the first survey (n = 5760 expected) will be sent a second questionnaire. Individuals will be eligible for the first survey if they are employed, have neither used nor applied for a rehabilitation programme during the last 4 years and neither received nor applied for a disability pension. The sample will be drawn randomly from the registers of the GPI North (n = 22,500) and the GPI Central Germany (n = 22,500) and stratified by sex and duration of sickness absence benefits. Barriers to rehabilitation services will be related to socio-demographic and social characteristics, pain and attitudes to pain, health and health behaviour, healthcare utilisation, experiences and cognitions about rehabilitation services and job conditions. Propensity score matched analyses will be used to examine the effectiveness of rehabilitation services. Data on use of medical rehabilitation will be extracted from administrative records. The primary outcome is pain disability. Secondary outcomes are pain intensity and days of disability, pain self-efficacy, fear avoidance beliefs, self-rated health, depression, healthcare utilisation, self-rated work ability and subjective prognosis of employability, sickness absence benefits, and disability pensions.

Discussion: This study identifies barriers to use of rehabilitation services and determines the effectiveness of medical rehabilitation for patients with chronic back pain.

Trial registration: German Clinical Trials Register ( DRKS00011554 , January 26, 2017).

Keywords: Access barriers; Back pain; Effectiveness; Medical rehabilitation; Propensity score matching.

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Conflict of interest statement

Ethics approval and consent to participate

The investigation conforms to the principles outlined in the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of the University of Lübeck (15–144) and the Martin Luther University Halle-Wittenberg (2015–49). Participation in the study is voluntary. Eligible patients will receive written information on study aims, participation requirements and the right to refuse. Consent for participation will be obtained by signature on the consent form. Participants have to send the signed consent form with the questionnaire to the university. The study has been registered in the German Clinical Trials Register (DRKS00011554) (Additional file 2).

This paper contains the original study protocol. Any substantial modifications to the study protocol will be submitted to the Ethics Committee of the University of Lübeck and the Martin Luther University Halle-Wittenberg for approval prior to implementation. Amendments will be documented in detail in the German Clinical Trials Register and will be described transparently in trial reports.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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Fig. 1
Flow of participants
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