A community pain service solution-focused pain management programme: delivery and preliminary outcome data

Aims: This article aims to describe the development of a specialist chronic facial pain (CFP) management programme within an already well-established pain management service, including the content from a multidisciplinary perspective, and present preliminary descriptive 6-month outcomes from patients who have attended the programme. Methods: Authors used their clinical experience of working with people who have a diagnosis of CFP. They researched available literature, liaised with CFP support organisations and visited an existing UK-based CFP programme. Programme content was designed based on findings. The roles of pain interdisciplinary team members involved in delivering the programme are described, as well as a brief description of the structure of the programme and programme sessions provided by each discipline. Results: Clinical outcomes from programme participants were collected at assessment, end of treatment and 6 months post-treatment, which measured relevant outcomes for a pain management programme (PMP). Outcomes from 36 participants at both end of programme and 6 months following completion of programme demonstrate promising improvements. Qualitative data from patient satisfaction questionnaires completed at the end of programme suggest that providing a CFP-specific programme was beneficial for participants, with the main critique being that the programme sessions should be longer than 45 minutes. Conclusion: Attending a CFP-specific programme demonstrated positive 6-month changes in relevant outcome measures for people with CFP. With a small sample size, there is a need for further research into the effectiveness. It would also be beneficial to compare outcomes from the usual PMP treatment with people who have CFP, with outcomes from a CFP-specific programme.

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Description of content, structure and theoretical model of a group-based pain management programme in the treatment of patients with persistent non-specific low back pain and psychological risk factors in a secondary sector setting

Clinical Rehabilitation ◽

10.1177/0269215521995185 ◽

2021 ◽

pp. 026921552199518

Author(s):

Mette Høj Skovbo ◽

Karina Agerbo ◽

Anna Jakobsen ◽

Stine Aalkjær Clausen ◽

Vivian Langagergaard ◽

...

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Pain Management ◽

Theoretical Foundation ◽

Management Programme ◽

Low Back ◽

Content Structure ◽

Cognitive Behavioural ◽

Intervention Description

Objective: To present the theoretical foundation and methodological considerations for a group-based pain management programme for patients with persistent non-specific low back pain and psychosocial risk factors. Method: The Template for Intervention Description and Replication (TIDieR) checklist was used as a framework for describing the content, structure and context of the program. The theoretical rationale underlying the pain management programme was described using the first three steps of the Intervention Mapping framework. The Fear-avoidance model and the Self-efficacy Theory were identified as the two main theories. These were used to establish specific factors addressed by the pain management programme as well as expected outcomes. Intervention description: A multidisciplinary, group-based programme using a cognitive-behavioural approach was developed. The programme consisting of six sessions of two hours duration, took place at a spine clinic at a regional hospital in Denmark. Psychoeducation and cognitive restructuring were specific strategies hypothesised to induce changes in outcome measures. The outcomes expected to change as a result of the intervention were disability, quality of life, sick leave and physical activity. A pilot study was performed, subsequent adjustments made and the final content and educational materials completed by January 2017. Conclusion: The theoretical foundation and underlying evidence for the hypothesised change mechanisms in the use of a cognitive-behavioural approach was presented. A theoretically sound and practically feasible intervention has been developed and its effectiveness is being determined in a randomised controlled trial, including 130 low back pain patients, which is currently underway.

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Determining the feasibility of a physiotherapist-led pain management programme for Arab patients with low back pain in Bahrain

Physiotherapy ◽

10.1016/j.physio.2016.10.230 ◽

2016 ◽

Vol 102 ◽

pp. e190-e191

Author(s):

D. Maki ◽

E. Rajab ◽

P. Watson ◽

D. Critchley

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Management ◽

Management Programme ◽

Low Back

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Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital

Musculoskeletal Care ◽

10.1002/msc.147 ◽

2009 ◽

Vol 7 (2) ◽

pp. 106-120 ◽

Cited By ~ 7

Author(s):

Mei Wong ◽

Julia Rietzschel ◽

Diarmuid Mulherin ◽

Carol David

Keyword(s):

Pain Management ◽

Community Hospital ◽

Management Programme

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The context of litigation in evaluating physical and psychological outcomes from pain management programmes

British Journal of Pain ◽

10.1177/2049463718820056 ◽

2018 ◽

Vol 13 (2) ◽

pp. 99-105 ◽

Cited By ~ 1

Author(s):

Hannah Twiddy ◽

Richard J Brown ◽

Hasan Waheed

Keyword(s):

Pain Management ◽

Employment Status ◽

Clinical Sample ◽

Management Programme ◽

Pain Clinic ◽

Assessment Procedure ◽

Healthcare Outcomes ◽

Meaningful Change ◽

Post Intervention ◽

Physical Measures

Objectives: There has been extensive research in evaluating chronic pain in the context of litigation while considering the implications that it can have on healthcare outcomes and rehabilitation progress. The aim of this article is to present retrospective observational data about the levels of disability and distress reported by patients with ongoing litigation at the start and following a UK-based multi-disciplinary pain management programme (PMP) when compared with those without litigation. Method: Between June 2014 and September 2017, 859 patients attended and completed a 16-day PMP at a tertiary-level National Health Service (UK) pain clinic. Patients were split into two groups: (1) litigation (n = 110) and (2) non-litigation (n = 749). As a part of the assessment procedure, the patients were given a battery of psychological and physical measures to complete over two time points. Results: Patients with litigation are statistically significantly more distressed at assessment but make comparable clinically meaningful change in PMP intervention when compared with a non-litigation sample. A very small proportion of the variance in depression scores post-treatment is accounted for by the context of litigation (0.5%), which may be accounted for by employment status. There was no effect of litigation on physical outcome post-intervention. Discussion: This article concludes that it is not appropriate to merely assume that the context of litigation results in limited positive psychological and physical outcomes post-PMP. There are some limitations to the clinical sample presented in respect to the conclusions.

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