Dropout in chronic pain management

The overall aim of this thesis was to gain more insight in the topic of dropout in IPMP and the factors related to dropout. In order to improve treatment outcomes in IPMP and to develop strategies to prevent dropout. We focused on two research objectives:
1. To identify predictors for dropout in IPMP
2. To explore patient perspectives on pain, treatment and health information in IPMP
With the first research objective we focused on characteristics that are available at baseline assessments in IPMP, which may be predictive for dropout from IPMP, this was addressed with a systematic review (Chapter 2) and a prospective cohort study (Chapter 3). Chapter 4 investigated the measurement properties of the translated an adapted version of the Treatment Beliefs Questionnaire (TBQ) of Cooper and colleagues. The TBQ was developed to measure patients’ beliefs of necessity of and concerns about rehabilitation, which were hypothesized, based on the literature to be related to dropout.
The focus of the second research objective was to examine patient perspectives on pain, treatment and health information in IPMP, which may provide more insight in patients’ adherence or non-adherence to treatment. Two theoretical frameworks informed the design of the studies: the Extended Common Sense Model (E-CSM) of Self-Regulation and the Integrated Conceptual Model of Health Literacy. This research objective was addressed with qualitative studies as described in the last two Chapters of this thesis: Chapter 5 and 6.
Chapter 7 comprises a general discussion of research findings of this PhD study.