Randomised controlled trials (RCTs) with at least three months of follow-up, assessing multidisciplinary treatments applied in a group setting for adult patients with chronic non-specific musculoskeletal pain (such as back pain or fibromyalgia) were eligible for inclusion in the review. Multidisciplinary treatments had to include at least three of the following categories to be eligible for inclusion: psychotherapy, physiotherapy, relaxation techniques, medical treatment or patient education and vocational therapy. The study had to include at least two of the following domains to be eligible for inclusion: pain, emotional strain, quality of life, disability, coping, physical capacity, return to work, sick leave, use of medicaments, use of the health care system, pain behaviour or subjective overall success. The primary outcomes of interest were psychological strain, disability in everyday life, health-related quality of life, pain and more appropriate coping strategies. Secondary outcomes of interest were physical capacity, return to work rate, sick leave, use of the health care system, medication, pain behaviour, quality of sleep and other domains (such as subjective improvement).
Most included studies were of patients with chronic low back or back pain. Others included patients with fibromyalgia or mixed chronic pain patients. Most multidisciplinary treatments were delivered in an outpatient setting with a treatment duration ranging from 15 to 135 hours (median 31 hours) over four to 15 weeks. Inpatient treatments were more intensive (median 150 hours over three to eight weeks). Control groups included non-multidisciplinary treatment strategies and waiting list or treatment as usual controls. The most common type of therapy was cognitive-behavioural therapy. Most studies also included a physical component, such as aerobic exercise, muscle stretching or exercise therapy. Most studies included a patient education component. Further details of included studies were presented.
Two reviewers independently assessed the studies for inclusion in the review; disagreements were resolved by consulting a third reviewer.