- Email: [email protected]
F658 PRELIMINARY OUTCOMES FROM AN ABBREVIATED INTERDISCIPLINARY PROGRAMME OF ACCEPTANCE AND COMMITMENT THERAPY FOR PATIENTS WITH CHRONIC PAIN
186
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
F658 PRELIMINARY OUTCOMES FROM AN ABBREVIATED INTERDISCIPLINARY PROGRAMME OF ACCEPTANCE AND COMMITMENT THERAPY FOR PATIENTS WITH CHRONIC PAIN G. Sowden1,2 *, K. Vowles1,2 , D. Beachill1 , N. Stanyer1 , J. Ashworth1,2 , J. Packham1,2 . 1 Interdisciplinary Musculoskeletal Pain Assessment and Community Treatment Service, Haywood Hospital, Stoke-on-Trent, 2 Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, UK
have developed algorithms for chronic pain treatment in different pathologies with regard to intensity and duration of pain. In our work we use different methods of treatment based on traditional and official medicine. Results: More than 100 thousand patients were successfully treated, there were defended more than 10 theses, several monographs were written, a sufficient number of specialists were trained to be able to work with patients with chronic pain. Today active researches and clinical work are underway.
Background and Aims: Chronic pain poses a significant burden to the individual sufferer, society and the health care system. Intensive group-based interdisciplinary pain rehabilitation programmes using Acceptance and Commitment Therapy (ACT) have demonstrated promising results, however, not all services have the resources to deliver this intensity of programme. This study therefore evaluates. a. the clinical outcomes and b. health care utilisation following an abbreviated interdisciplinary pain rehabilitation programme offered in a community hospital setting. Methods: Data was collected from 60 patients with chronic pain who completed the programme (seven hours of treatment per day, two days per week for four weeks). Outcomes included measures of physical and psychosocial functioning and pain-related healthcare visits and frequency of interventions for pain. Outcomes were assessed immediately following treatment and at 3 month and 12 month follow-ups. Results: There were significant reductions in overall physical and psychosocial disability (effect size 0.65 and 1.0, respectively) and emotional functioning (effect size – depression: 0.98; pain-related fear: 0.82) immediately following programme. There was good maintenance of treatment gains at 3 and 12 months. Pain-related healthcare visits were significantly reduced at 3 and 12 months follow-ups (effect size 0.69). Secondary analysis suggests that the most physically disabled patients (low pre-programme walking physical performance) did less well post programme and at followups. Conclusions: These data suggest that an abbreviated ACT programme shows good treatment effectiveness even through longer-term follow-ups for the majority of patients. The most physically disabled patients, however, may require more intensive treatment.
Disclosure: None declared
Disclosure: None declared
Disclosure: None declared
F659 MULTIDISCIPLINARY APPROACH IN PAIN TREATMENT IN RUSSIA O. Zagorulko1 *, A. Gnezdilov2 , N. Samoylova2 , L. Medvedeva2 . 1 National Research Center of Surgery Russian Academy of Medical Science, 2 Pain Treatment, National Research Center of Surgery Russian Academy of Medical Science, Moscow, Russia
F661 STAYING AT WORK WITH CHRONIC MUSCULOSKELETAL PAIN: A NEW REFERENCE FOR PAIN REHABILITATION H.J. de Vries1 *, S. Brouwer2 , J.W. Groothoff2 , J.H.B. Geertzen1 , M.F. Reneman1 . 1 Department of Rehabilitation Medicine, 2 Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Background: The structure of centers and clinics for pain treatment in Russia varies. We attempted to integrate all the existing methods of acute and chronic pain treatment. Methods: The Department of pain syndromes was organized for the first time in Russia in 1976 on the basis of anesthesiology. At first the work of the department was aimed at studying various types of drug-free anesthesia, the scientific rationale for the causes and long-term duration of pain syndrome and determination of possible methods of its treatment. Originally the department staff consisted of anesthesiologists, physiologists, and neurologists. The department expanded gradually. There was a need to involve doctors of other specialties: traumatologists, psychologists, reflexologists, physiotherapists, masseurs, physical training doctors. Studying the causes of chronic pain syndrome development, its duration and possible ways of its treatment it became clear to us that the problem was complex and that it should be solved by the efforts of a wide range of specialists. We
F660 EFFECTIVENESS AND COST-EFFECTIVENESS OF SHORTENING REHABILITATION PROGRAMS FOR PATIENTS WITH CHRONIC MUSCULOSKELETAL PAIN; DESIGN OF A RCT F.P.C. Waterschoot *, J.H.B. Geertzen, P.U. Dijkstra, M.F. Reneman. Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands Background and Aims: Pain Rehabilitation Programs (PRP’s) are proven effective for patients with chronic musculoskeletal pain (CMP). Evidence about the relationship of dose on the effect of PRP however, is unavailable. We hypothesized that shortening PRP will not be inferior to care as usual. The aim of the RCT is to analyse the effect of shortening duration of PRP on effectiveness and cost effectiveness of PRP. Methods: The study will be a single blind, 2 armed, randomized controlled clinical trial, with a non inferiority design. A total of 264 patients with CMP referred to outpatient multidisciplinary PRP will be included for the study. The control intervention will be care as usual. Three programs will be applied with durations of 12, 16 or 20 weeks, depending on the complexity The experimental group will receive PRP in 4 weeks less than care as usual, while the experimental intervention will not differ in content. Pain related disability, measured with the Pain Disability Index (PDI), will be the main outcome. The non-inferiority margin is predefined as 4 points difference on PDI to tolerate as non-inferior. For cost-effectiveness direct and indirect costs will be calculated. Patients will complete questionnaires at baseline, end of PRP and at 3 and 12 months follow up. Inclusion: 2 years starting September 2011. Results: Not available. Conclusions: This will be the first RCT ever in the PRP field to study dose variables.
Background and Aims: Chronic nonspecific musculoskeletal pain (CMP) results often in work disability and sick-leave, confronting employers, insurance companies, and society with considerable costs. However, a substantial amount of workers stay at work despite CMP. It is currently unknown on which factors people who stay at work despite CMP differ from those who do not. Attention to workers who stay at work despite CMP will enlarge our understanding of work participation in people with CMP. The main question of this study was: what are the characteristics of workers who manage to stay at work despite CMP, and what can be learned from this successful group? Methods: Cross-sectional design. Medical, physical, psychological and social variables of workers who stay at work with CMP were described (n = 120), and compared with sick-listed workers with CMP who sought multidisciplinary pain rehabilitation care (n = 120).
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
F658 PRELIMINARY OUTCOMES FROM AN ABBREVIATED INTERDISCIPLINARY PROGRAMME OF ACCEPTANCE AND COMMITMENT THERAPY FOR PATIENTS WITH CHRONIC PAIN G. Sowden1,2 *, K. Vowles1,2 , D. Beachill1 , N. Stanyer1 , J. Ashworth1,2 , J. Packham1,2 . 1 Interdisciplinary Musculoskeletal Pain Assessment and Community Treatment Service, Haywood Hospital, Stoke-on-Trent, 2 Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, UK
have developed algorithms for chronic pain treatment in different pathologies with regard to intensity and duration of pain. In our work we use different methods of treatment based on traditional and official medicine. Results: More than 100 thousand patients were successfully treated, there were defended more than 10 theses, several monographs were written, a sufficient number of specialists were trained to be able to work with patients with chronic pain. Today active researches and clinical work are underway.
Background and Aims: Chronic pain poses a significant burden to the individual sufferer, society and the health care system. Intensive group-based interdisciplinary pain rehabilitation programmes using Acceptance and Commitment Therapy (ACT) have demonstrated promising results, however, not all services have the resources to deliver this intensity of programme. This study therefore evaluates. a. the clinical outcomes and b. health care utilisation following an abbreviated interdisciplinary pain rehabilitation programme offered in a community hospital setting. Methods: Data was collected from 60 patients with chronic pain who completed the programme (seven hours of treatment per day, two days per week for four weeks). Outcomes included measures of physical and psychosocial functioning and pain-related healthcare visits and frequency of interventions for pain. Outcomes were assessed immediately following treatment and at 3 month and 12 month follow-ups. Results: There were significant reductions in overall physical and psychosocial disability (effect size 0.65 and 1.0, respectively) and emotional functioning (effect size – depression: 0.98; pain-related fear: 0.82) immediately following programme. There was good maintenance of treatment gains at 3 and 12 months. Pain-related healthcare visits were significantly reduced at 3 and 12 months follow-ups (effect size 0.69). Secondary analysis suggests that the most physically disabled patients (low pre-programme walking physical performance) did less well post programme and at followups. Conclusions: These data suggest that an abbreviated ACT programme shows good treatment effectiveness even through longer-term follow-ups for the majority of patients. The most physically disabled patients, however, may require more intensive treatment.
Disclosure: None declared
Disclosure: None declared
Disclosure: None declared
F659 MULTIDISCIPLINARY APPROACH IN PAIN TREATMENT IN RUSSIA O. Zagorulko1 *, A. Gnezdilov2 , N. Samoylova2 , L. Medvedeva2 . 1 National Research Center of Surgery Russian Academy of Medical Science, 2 Pain Treatment, National Research Center of Surgery Russian Academy of Medical Science, Moscow, Russia
F661 STAYING AT WORK WITH CHRONIC MUSCULOSKELETAL PAIN: A NEW REFERENCE FOR PAIN REHABILITATION H.J. de Vries1 *, S. Brouwer2 , J.W. Groothoff2 , J.H.B. Geertzen1 , M.F. Reneman1 . 1 Department of Rehabilitation Medicine, 2 Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Background: The structure of centers and clinics for pain treatment in Russia varies. We attempted to integrate all the existing methods of acute and chronic pain treatment. Methods: The Department of pain syndromes was organized for the first time in Russia in 1976 on the basis of anesthesiology. At first the work of the department was aimed at studying various types of drug-free anesthesia, the scientific rationale for the causes and long-term duration of pain syndrome and determination of possible methods of its treatment. Originally the department staff consisted of anesthesiologists, physiologists, and neurologists. The department expanded gradually. There was a need to involve doctors of other specialties: traumatologists, psychologists, reflexologists, physiotherapists, masseurs, physical training doctors. Studying the causes of chronic pain syndrome development, its duration and possible ways of its treatment it became clear to us that the problem was complex and that it should be solved by the efforts of a wide range of specialists. We
F660 EFFECTIVENESS AND COST-EFFECTIVENESS OF SHORTENING REHABILITATION PROGRAMS FOR PATIENTS WITH CHRONIC MUSCULOSKELETAL PAIN; DESIGN OF A RCT F.P.C. Waterschoot *, J.H.B. Geertzen, P.U. Dijkstra, M.F. Reneman. Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands Background and Aims: Pain Rehabilitation Programs (PRP’s) are proven effective for patients with chronic musculoskeletal pain (CMP). Evidence about the relationship of dose on the effect of PRP however, is unavailable. We hypothesized that shortening PRP will not be inferior to care as usual. The aim of the RCT is to analyse the effect of shortening duration of PRP on effectiveness and cost effectiveness of PRP. Methods: The study will be a single blind, 2 armed, randomized controlled clinical trial, with a non inferiority design. A total of 264 patients with CMP referred to outpatient multidisciplinary PRP will be included for the study. The control intervention will be care as usual. Three programs will be applied with durations of 12, 16 or 20 weeks, depending on the complexity The experimental group will receive PRP in 4 weeks less than care as usual, while the experimental intervention will not differ in content. Pain related disability, measured with the Pain Disability Index (PDI), will be the main outcome. The non-inferiority margin is predefined as 4 points difference on PDI to tolerate as non-inferior. For cost-effectiveness direct and indirect costs will be calculated. Patients will complete questionnaires at baseline, end of PRP and at 3 and 12 months follow up. Inclusion: 2 years starting September 2011. Results: Not available. Conclusions: This will be the first RCT ever in the PRP field to study dose variables.
Background and Aims: Chronic nonspecific musculoskeletal pain (CMP) results often in work disability and sick-leave, confronting employers, insurance companies, and society with considerable costs. However, a substantial amount of workers stay at work despite CMP. It is currently unknown on which factors people who stay at work despite CMP differ from those who do not. Attention to workers who stay at work despite CMP will enlarge our understanding of work participation in people with CMP. The main question of this study was: what are the characteristics of workers who manage to stay at work despite CMP, and what can be learned from this successful group? Methods: Cross-sectional design. Medical, physical, psychological and social variables of workers who stay at work with CMP were described (n = 120), and compared with sick-listed workers with CMP who sought multidisciplinary pain rehabilitation care (n = 120).