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Moving with Pain A Physiotherapy Led Pain Management Programme Pauline Campbell and Elizabeth Connolly-Anderson Physiotherapy Department, Altnagelvin Area.

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Presentation on theme: "Moving with Pain A Physiotherapy Led Pain Management Programme Pauline Campbell and Elizabeth Connolly-Anderson Physiotherapy Department, Altnagelvin Area."— Presentation transcript:

1 Moving with Pain A Physiotherapy Led Pain Management Programme Pauline Campbell and Elizabeth Connolly-Anderson Physiotherapy Department, Altnagelvin Area Hospital, WHSCT

2  Chronic Pain Incidence  NI Context  Previous Service Provision  The Way Forward  “Moving with Pain” Programme  Outcome Measures  Quantitative and Qualitative results  The Future Overview

3  Uk Average; 1 in 7 (7.8 million people)  Regional Figures:  North East/Yorkshire9.0%  North West16.5%  East Midlands9.3%  West Midlands17.5%  East12.9%  London14.3%  South East13.2%  South West13.4%  Wales9.9%  Scotland18.1%  Northern Ireland19.0% Chronic Pain Incidence (Breivik et al, 2006)

4  2005 – Raft of recommendations for how pain services could be improved  2010 – ‘little progression for these recommendations’ (apart from CREST guidelines, 2008)   19.4% of people in NI aged have experienced sexual violence or abuse (French & Freel, 2009)  Ilex Briefing (2009), Derry-Londonderry - ‘large proportions of children living in poverty, low employment rates, large numbers of families reliant on benefits, premature mortality and poor educational outcomes  WHSCT MSK “Core” Physiotherapy- 90% Chronic MSK Pain Referrals NI Context

5  Biomedical Ax  1:1 Treatment  Functional Rehab Class  Little use of Outcome measures  Perceived high re-referral rates  High Dropout rates  Reported Barriers to participation WHSCT: Previous Physiotherapy Provision

6 The Way Forward Biopsychosocial Assessment PATIENT Outcome measures Evidenced Based Practice Patient Feedback Education Self Management StaffGroup

7  Clinical Guidelines in Chronic Pain Management were reviewed – European Chronic Low Back Pain (2004), NICE Persistent Low Back Pain (2009)  Systematic reviews of the evidence for chronic musculoskeletal pain management were conducted  A multimodal programme was devised  Evidence based components:  Education  Relaxation Training  Goal Setting  Exercise Evidence Review

8 Outcomes Measures  Outcome measures were chosen in accordance with the IMMPACT recommendations of core outcome measures in chronic pain clinical trials (Dworkin et al, 2005)  BPI, PSEQ, PGIC  A qualitative study was conducted to capture service users’ lived experience with chronic pain  Re-referral rates to the physiotherapy were also examined

9  Venn Diagram summarises qualitative analysis of 111 feedback forms ‘Moving With Pain’ Patient Feedback

10 Quantitative Results Clinical Outcome Measure PrePostStatistical Significance BPI – ‘worst pain’7.2 (4.03)6.77 (4.02)p 0.02 PSEQ - mean2.5 (1.61)2.87 (1.62)p <0.001 PGICN/A3.61 (1.61)N/A Re-Referral Rate PrePostStatistical Significance 0.08 (27.11)0.01 (13.86)p <0.001

11  The ‘Moving With Pain’ programme was unanimously selected by the judges from a very strong field. It is commended for an innovative approach to overcoming the fear of moving with pain in those with musculoskeletal pain. Their robust outcome measures showed considerable movement over a traditional functional rehabilitation programme and patient satisfaction was high. Referral to the physiotherapy department was reduced by 87%, a significant reduction in cost and resource. NI Healthcare Awards 2014 Pain Management Programme of the Year Judges’ Comments

12 The Future…  Moving with Pain available Trust Wide  Staff Development - Economies of time, lack of staff skills or other resources risk reducing the effectiveness of the programme to a point where gains are insignificant.  Group for < 18yr olds  Patient Involvement-focus Group and 1 year follow-up  Application for funding for Tea/coffee and Primary Care/Community Setting


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