Remote Delivery of the Chronic Pain Self-management Program Using Self-directed Materials and Small-group Telephone Support: A Pilot Study

A remote (telephone and tool kit) chronic pain program was studied using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. This 6-week pilot took place in underserved communities in Cleveland, Ohio. We determined reach by the diversity of the population, nearly 50% Black and mostly low income. Effectiveness over 7 weeks was shown with validated instruments (depression, pain, sleep, quality of life, self-rated health, and self-efficacy). Changes in pain, depression, and self-efficacy were significant. ( p < .01). Remote implementation was accomplished by sending participants a box of materials (book, exercise and relaxation CDs, a self-test, and tip sheets). Participants also participated in peer-facilitated, weekly, scripted telephone calls. Maintenance was demonstrated as the study site has offered nine additional programs with more plan. In addition, 60 additional organizations are now offering the program. This proof-of-concept study offers an alternate to in-person chronic pain self-management program delivery.

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Capsule Commentary on Turner et al., Randomized Trial of Chronic Pain Self-management Program in Community or Clinic for Low-Income Primary Care Patients

Journal of General Internal Medicine ◽

10.1007/s11606-018-4370-5 ◽

2018 ◽

Vol 33 (5) ◽

pp. 746-746

Author(s):

Lauren S. Penney

Keyword(s):

Primary Care ◽

Chronic Pain ◽

Randomized Trial ◽

Low Income ◽

Management Program ◽

Self Management ◽

Community Or ◽

Primary Care Patients

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Randomized Trial of Chronic Pain Self-Management Program in the Community or Clinic for Low-Income Primary Care Patients

Journal of General Internal Medicine ◽

10.1007/s11606-017-4244-2 ◽

2018 ◽

Vol 33 (5) ◽

pp. 668-677 ◽

Cited By ~ 12

Author(s):

Barbara J. Turner ◽

Yuanyuan Liang ◽

Maureen J. Simmonds ◽

Natalia Rodriguez ◽

Raudel Bobadilla ◽

...

Keyword(s):

Primary Care ◽

Chronic Pain ◽

Randomized Trial ◽

Low Income ◽

Management Program ◽

Self Management ◽

Community Or ◽

Primary Care Patients

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Chronic Pain Self-Management Program for Low-Income Patients: Themes from a Qualitative Inquiry

Pain Medicine ◽

10.1093/pm/pny192 ◽

2018 ◽

Vol 21 (2) ◽

pp. e1-e8 ◽

Cited By ~ 1

Author(s):

Barbara J Turner ◽

Natalia Rodriguez ◽

Raudel Bobadilla ◽

Arthur E Hernandez ◽

Zenong Yin

Keyword(s):

Chronic Pain ◽

Focus Group ◽

Qualitative Study ◽

Focus Groups ◽

Low Income ◽

Pain Medication ◽

Management Program ◽

Qualitative Inquiry ◽

Self Management ◽

Theory Approach

Abstract Objective To examine factors influencing initial engagement, ongoing participation, learned behaviors, and subjective functional outcomes after a trial of the Living Better Beyond Pain (LBBP) chronic pain self-management program. Design Qualitative study using the Grounded Theory approach. Setting Two 60-minute focus groups and phone interviews in May 2017. Subjects Focus groups with 18 participants who completed LBBP and six-month measures; telephone interviews with 17 participants who stopped attending. Methods Study coordinators randomly selected program completers for focus groups and conducted phone interviews with noncompleters. Inductive thematic analysis was used to identify patterns in semantic content with a recursive process applied to focus group transcripts and interview transcriptions to codify into themes. Themes were categorized according to the Theory of Planned Behavior. Results Focus group and telephone interview participants were primarily Hispanic and unemployed. Attitudes fostering participation in LBBP included dissatisfaction with the status quo, need to reduce pain medication, and lack of training and knowledge about chronic pain. Positive social norms from meeting others with chronic pain and support from the LBBP team encouraged attendance and adoption of behaviors. Transportation, pain, and competing activities were barriers, whereas adapting activities for the disabled was a facilitator. Maintaining behaviors and activities at home was challenging but ultimately rewarding due to improvement in daily function with less pain medication. Conclusions This qualitative study complements quantitative results showing clinically significant improvements in function after the LBBP program by adding practical insights into ways to increase participation and outcomes. Participants strongly endorsed the need for chronic pain self-management training.

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Evaluation of a Fatigue Self-Management Program for People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2015-019 ◽

2016 ◽

Vol 18 (3) ◽

pp. 116-121 ◽

Cited By ~ 10

Author(s):

Hilda Mulligan ◽

Amanda Wilkinson ◽

Amelia Barclay ◽

Hayley Whiting ◽

Christelle Heynike ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Self Efficacy ◽

Short Form ◽

Small Sample Size ◽

Management Program ◽

Small Sample ◽

Self Report ◽

Self Management

Background: Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS). The program “Minimise Fatigue, Maximise Life: Creating Balance with Multiple Sclerosis” (MFML) was created in New Zealand because of the lack of a fatigue management program for people with MS in that country. This program aims to empower individuals with MS to manage their own symptoms of fatigue. The objective of this study was to evaluate the MFML fatigue self-management program. Methods: Self-report questionnaires were used to measure impact of fatigue (5-item Modified Fatigue Impact Scale), self-efficacy (MS Self-efficacy Scale), and quality of life (12-item Short Form Health Status Survey [SF-12]) 1 month before (T1), at commencement of (T2) (to investigate the stability of questionnaire scores before the intervention), and at the end of (T3) the 6-week group-based program. Increased self-efficacy and quality of life scores and a decrease in reported impact of fatigue were the anticipated primary outcomes, with participants acting as their own controls. Results: Twenty-five women (aged 37–63 years) participated. Stability of scores for all the questionnaires was evidenced between T1 and T2. After the intervention (T3), scores showed a significant improvement in self-efficacy and impact of fatigue, with large effect sizes, but no change in either the physical or mental component summary of the SF-12. Conclusions: Despite the small sample size, this study showed an organized approach to the management of fatigue for people living with MS, and its outcomes demonstrated benefits for participants.

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Effectiveness of a Peer-Led Pain Management Program in Relieving Chronic Pain and Enhancing Pain Self-Efficacy Among Older Adults: A Clustered Randomized Controlled Trial

Frontiers in Medicine ◽

10.3389/fmed.2021.709141 ◽

2021 ◽

Vol 8 ◽

Author(s):

Mimi M. Y. Tse ◽

Shamay S. M. Ng ◽

Paul H. Lee ◽

Xue Bai ◽

Raymond Lo ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Pain Management ◽

Self Efficacy ◽

Nursing Home Residents ◽

Management Program ◽

Control Group ◽

Pain Management Program ◽

Experimental Group

Chronic pain is common in nursing home residents, who may have difficulty seeking out pain management strategies. Peer support model show promise as a strategy for managing chronic conditions. This was a clustered randomized controlled trial. A peer-led pain management program was provided for the experimental group. Pain situation, depression, quality of life, non-drug strategies used, and pain knowledge were measured. A total of 262 participants joined the study (146 were allocated as experimental group and 116 as control group). Before our intervention, the mean pain score reported was as high as 6.36 on a 10-point Likert Scale. The high intensity of their pain very much interfered with the daily activities of the participants. Pain interference was high and the participants had poor coping as indicated by the low pain self-efficacy. Depression and a low quality of life score was found. Upon completion of our PAP, there was a significant increase in pain self-efficacy, pain interference as well as quality of life for the participants in the experimental group and not in the control group, and this improvement sustained in 3-month follow up. The present study used a peer support models and proven to be effective in managing pain and pain related situations for nursing home residents with chronic pain. The peer volunteers involved in the pain management program taught relevant pain knowledge and pain management strategies to help our participants.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03823495, NCT03823495.

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