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Permanent link (DOI): https://doi.org/10.7939/R3B853S05

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UTILITY OF THE OREBRO MUSCULOSKELETAL PAIN QUESTIONNAIRE AS A SCREENING AND CLINICAL DECISION SUPPORT TOOL IN WORKERS’ COMPENSATION CLAIMANTS Open Access

Descriptions

Other title
Subject/Keyword
Return to work
Clinical decision support tool
Orebro Musculoskeletal Pain Questionnaire
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Aravena, Hilda Ivania
Supervisor and department
Geoffrey Bostick (Rehabilitation Medicine)
Douglas Gross (Rehabilitation Medicine)
Examining committee member and department
Douglas Gross (Rehabilitation Medicine)
David Magee (Rehabilitation Medicine)
Geoffrey Bostick (Rehabilitation Medicine)
Department
Faculty of Rehabilitation Medicine
Specialization
Rehabilitation Science
Date accepted
2014-08-12T11:47:12Z
Graduation date
2014-11
Degree
Master of Science
Degree level
Master's
Abstract
Patient health status questionnaires are often used as screening tools by health care professionals. The Orebro Musculoskeletal Pain Questionnaire (OMPQ) is a screening tool for patients with musculoskeletal disorders that targets not only physical impairment but also psychosocial factors. According to several authors, psychosocial factors (an example of a “yellow flags”) are a key component in the transition from an acute to a chronic musculoskeletal condition, implying the importance of early and correct identification. In addition to identifying psychosocial risk factors, the OMPQ allocates patients into three different risk categories related to work absenteeism and guides potential interventions. The OMPQ has been evaluated in different clinical settings as a screening instrument, but never for its utility as a clinical decision support tool to guide treatment selection. This thesis investigates the potential usefulness of the OMPQ to allocate injured workers into different risk categories that are related to different rehabilitation programs. The goal is to gain knowledge regarding whether or not this screening tool can be used with confidence for supporting clinician decisions. A retrospective study design was used using a database previously developed from clinical and administrative information. Firstly, descriptive statistics were calculated for the injured workers based on OMPQ categorization. Secondly, the level of agreement between the OMPQ categories was examined along with clinician recommendations and the actual rehabilitation programs undertaken by the claimants. Finally, we examined whether a match between OMPQ categories, clinician recommendations and the actual rehabilitation program undertaken was related to a better return to work outcome. WCB claimants were characterized based on common measures such as pain intensity and self-reported for each OMPQ category. In this dataset, it appeared that the OMPQ had limited agreement with clinician recommendations suggesting other measures or factors are considered when making treatment recommendations. Finally, concordance of OMPQ categorization and actual rehabilitation undertaken did not appear to favorably impact the administrative outcome time to claim closure. Our results do not support the use of the OMPQ as a clinical decision support tool for selecting rehabilitation interventions for workers’ compensation claimants. The level of agreement between the recommendations made by the OMPQ and those made by clinicians was low, despite using two cut-off points widely accepted in the jurisdiction. In many cases, a good outcome resulted despite a lack of match between OMPQ recommendations and actual rehabilitation programs; by contrast, a match between clinician recommendations and the actual rehabilitation program resulted in a good RTW outcome for the majority of claimants (78.3%). However, this does not mean that this screening tool is ineffective. What may be required is further refinement of the process in order to produce a final OMPQ score that allows a classification into three different risk categories. This means that it would be useful for the OMPQ to include subscales determined by specific barriers, rather than merely expressing an overall sum of diverse factors such as pain, function, disability, and psychological and social attributes.
Language
English
DOI
doi:10.7939/R3B853S05
Rights
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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