Chronic Pain and Labour Market Affiliation: Effect of Demographic Factors and Comorbidities 5 Years Before and
Lea Stevnsborg1, Magnus Pedersen1, Lilli Kirkeskov1
1Department of Social Medicine, Frederiksberg Hospital, Copenhagen, Denmark.
Purpose:
This study investigates the association of sociodemographic factors and comorbidities with labour market affiliation among patients with non-malignant chronic pain treated at multidisciplinary pain centres in Denmark.
Methods:
This registry-based cohort study used data from the nationwide Danish Civil Registration System and Danish National Patient Registry. Patients treated at multidisciplinary pain centres in 2013-2017 were included. Labour market affiliation was assessed 5 years before and 2 years after treatment and at treatment initiation (baseline). Sequence and logistic regression analyses were used to identify associations.
Results:
2375 patients (median age 47 years, female 64%, comorbidity: Mean Charlson's comorbidity score: 0.88, affective disorder: 45%, anxiety disorder: 37.0%, personality disorder: 7.8%) were included. At treatment initiation, only 34.2% of patients were employed, compared to 58.6% 5 years before treatment. Sequence analysis revealed that most patients remained in or transitioned to a 'no labour market affiliation' state. Factors significantly associated with labour market affiliation across timepoints included age (adjusted odd ratio [aOR] and 95% confidence interval [CI]age 56-65 = 0.51 [0.38-0.69]), marital status (aORcohabitant = 1.58 [1.30-1.92]), education level (aORhigh = 4.56 [3.51-5.93]), immigrant status (aORnon-western = 0.35 [0.26-0.45]) and psychiatric comorbidities (aORaffective disorders = 0.67 [0.56-0.87]).
Conclusion:
Patients with high-impact, treatment-resistant chronic pain face early labour market detachment, highlighting the need for timely, equitable interventions to support employment, especially among vulnerable groups.
Significance Statement:
The study offers new evidence on how socioeconomic and psychiatric comorbid vulnerabilities shape long-term labour market affiliation before relevant multidisciplinary treatment is initiated and suggests that key intervention opportunities for at-risk patients may be missed under current practice.
