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Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course

OBJECTIVE: To devise and test a self-management course for chronic pain patients based on evidence and underpinned by theory using the Medical Research Council (MRC) framework for developing complex interventions. DESIGN: We used a mixed method approach. We conducted a systematic review of the effec...

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Autores principales: Carnes, Dawn, Homer, Kate, Underwood, Martin, Pincus, Tamar, Rahman, Anisur, Taylor, Stephanie J C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831098/
https://www.ncbi.nlm.nih.gov/pubmed/24231458
http://dx.doi.org/10.1136/bmjopen-2013-003534
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author Carnes, Dawn
Homer, Kate
Underwood, Martin
Pincus, Tamar
Rahman, Anisur
Taylor, Stephanie J C
author_facet Carnes, Dawn
Homer, Kate
Underwood, Martin
Pincus, Tamar
Rahman, Anisur
Taylor, Stephanie J C
author_sort Carnes, Dawn
collection PubMed
description OBJECTIVE: To devise and test a self-management course for chronic pain patients based on evidence and underpinned by theory using the Medical Research Council (MRC) framework for developing complex interventions. DESIGN: We used a mixed method approach. We conducted a systematic review of the effectiveness of components and characteristics of pain management courses. We then interviewed chronic pain patients who had attended pain and self-management courses. Behavioural change theories were mapped onto our findings and used to design the intervention. We then conducted a feasibility study to test the intervention. SETTING: Primary care in the inner city of London, UK. PARTICIPANTS: Adults (18 years or older) with chronic musculoskeletal pain. OUTCOMES: Related disability, quality of life, coping, depression, anxiety, social integration and healthcare resource use. RESULTS: The systematic reviews indicated that group-based courses with joint lay and healthcare professional leadership and that included a psychological component of short duration (<8 weeks) showed considerable promise. The qualitative research indicated that participants liked relaxation, valued social interaction and course location, and that timing and good tutoring were important determinants of attendance. We used behavioural change theories (social learning theory and cognitive behaviour approaches (CBA)) to inform course content. The course addressed: understanding and accepting pain, mood and pain, unhelpful thoughts and behaviour, problem solving, goal setting, action planning, movement, relaxation and social integration/reactivation. Attendance was 85%; we modified the recruitment of patients, the course and the training of facilitators as a result of testing. CONCLUSIONS: The MRC guidelines were helpful in developing this intervention. It was possible to train both lay and non-psychologists to facilitate the courses and deliver CBA. The course was feasible and well received.
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spelling pubmed-38310982013-11-18 Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course Carnes, Dawn Homer, Kate Underwood, Martin Pincus, Tamar Rahman, Anisur Taylor, Stephanie J C BMJ Open Health Services Research OBJECTIVE: To devise and test a self-management course for chronic pain patients based on evidence and underpinned by theory using the Medical Research Council (MRC) framework for developing complex interventions. DESIGN: We used a mixed method approach. We conducted a systematic review of the effectiveness of components and characteristics of pain management courses. We then interviewed chronic pain patients who had attended pain and self-management courses. Behavioural change theories were mapped onto our findings and used to design the intervention. We then conducted a feasibility study to test the intervention. SETTING: Primary care in the inner city of London, UK. PARTICIPANTS: Adults (18 years or older) with chronic musculoskeletal pain. OUTCOMES: Related disability, quality of life, coping, depression, anxiety, social integration and healthcare resource use. RESULTS: The systematic reviews indicated that group-based courses with joint lay and healthcare professional leadership and that included a psychological component of short duration (<8 weeks) showed considerable promise. The qualitative research indicated that participants liked relaxation, valued social interaction and course location, and that timing and good tutoring were important determinants of attendance. We used behavioural change theories (social learning theory and cognitive behaviour approaches (CBA)) to inform course content. The course addressed: understanding and accepting pain, mood and pain, unhelpful thoughts and behaviour, problem solving, goal setting, action planning, movement, relaxation and social integration/reactivation. Attendance was 85%; we modified the recruitment of patients, the course and the training of facilitators as a result of testing. CONCLUSIONS: The MRC guidelines were helpful in developing this intervention. It was possible to train both lay and non-psychologists to facilitate the courses and deliver CBA. The course was feasible and well received. BMJ Publishing Group 2013-11-14 /pmc/articles/PMC3831098/ /pubmed/24231458 http://dx.doi.org/10.1136/bmjopen-2013-003534 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Health Services Research
Carnes, Dawn
Homer, Kate
Underwood, Martin
Pincus, Tamar
Rahman, Anisur
Taylor, Stephanie J C
Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
title Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
title_full Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
title_fullStr Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
title_full_unstemmed Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
title_short Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
title_sort pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831098/
https://www.ncbi.nlm.nih.gov/pubmed/24231458
http://dx.doi.org/10.1136/bmjopen-2013-003534
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