A comparison of two multidisciplinary inpatient rehabilitation programmes for fibromyalgia: a register linkage study on work disability.

BACKGROUND: Patients with fibromyalgia have a high risk of temporary and permanent work disability. Little is known about the effects of fibromyalgia rehabilitation on work disability. OBJECTIVE: To determine whether a specific fibromyalgia rehabilitation programme is superior to a non-specific musculoskeletal rehabilitation of patients with fibromyalgia in terms of work disability. METHODS: A prospective observational study of 215 local government employees with a 6-year post-intervention follow-up to monitor the occurrence of long sick-leave and disability pensions among the participants of two different fibromyalgia rehabilitation programmes. RESULTS: Specific fibromyalgia rehabilitation was not superior to a non-specific musculoskeletal rehabilitation, with the corresponding hazard ratios (95% confidence intervals) after adjustments being 1.02 (0.75-1.40) for long sick-leave, 1.18 (0.75-1.87) for very long sick-leave, and 1.07 (0.63-1.83) for disability pension. CONCLUSION: The results suggest that in reducing work disability among patients with fibromyalgia a specific multidisciplinary fibromyalgia rehabilitation programme practised in Finland provides no benefit compared with non-specific multidisciplinary musculoskeletal rehabilitation. Further research is needed to develop an optimal programme (or several different programmes) to control the burden of work disability related to fibromyalgia.

Allocation of rehabilitation measures provided by the Social Insurance Institution in Finland: a register linkage study.

OBJECTIVE: To study the allocation of rehabilitation measures provided by the Finnish Social Insurance Institution in relation to the characteristics and health status of rehabilitants. DESIGN: A register linkage study. SUBJECTS: A total of 67,106 full-time local government employees with a minimum of 10-month job contracts in 10 Finnish towns during the period 1994-2002. METHODS: Data on the rehabilitation granted between 1994 and 2002, special medication reimbursements for chronic diseases, and disability retirement, were derived from the registers of the Social Insurance Institution as an indicator of chronic morbidity and linked to the employers' records on demographic characteristics and rates of sickness absence. RESULTS: In comparison with non-rehabilitants, the rate of sickness absence (> 21 days) was 2.2-2.9-fold (95% confidence interval (CI) 2.0-3.0) higher, the odds ratios of special medication reimbursement 1.5-6.1-fold (95% CI 1.3-6.9) higher and disability retirement 3.1-7.5-fold (95% CI 2.7-9.3) higher among rehabilitants. Older women and employees in manual or lower-grade non-manual jobs predominated in the rehabilitation groups. The proportion of temporary employees receiving rehabilitation was low. CONCLUSION: Permanently employed older women with an excess burden of health problems predominate in the receipt of rehabilitation provided by the Social Insurance Institution.