1. PAIN MANAGEMENT PROGRAMME HILLINGDON HOSPITAL AIMS OF PRESENTATION:  PROVIDE AN OVERVIEW OF THE PAIN MANAGEMENT PROGRAMME.  SHOW OUTCOME INFORMATION Simon Dupont Pain Management Programme Greenacres Centre

2. The Pain Management Programme  Multidisciplinary Service Clinical Psychologist Occupational Therapist Physiotherapist  Two programmes targeting different patient groups.  NICE recommended (2009)  Low back / musculoskeletal pain >6 weeks

3. The Programmes 8 WEEK PAIN MANAGEMENT PROGRAMME (PMP) 4 WEEK PAIN COPING STRATEGIES (PCS) Referrals accepted to either programme from GP’s – either ICE or paper Consultants Physiotherapists Extended Scope Practitioners Specialist Nurses Occupational Therapists

4. The Pain Management Approach  Group format using a Cognitive Behavioural (CBT) model.  Takes into account the multisystem impact of pain (physical, functional and emotional aspects).  Attempts to develop acceptance and ability to live with pain using effective coping strategies.  Desired outcome: to increase activity despite pain. Not to cure.

5. Prompts for Referral  Chronic pain with a reduced sense of control over life  Loss of self confidence  Some degree of mood disturbance  Unhelpful beliefs about pain (e.g. catastrophizing)  Loss of quality of life  Reduced activity levels  Decreased levels of social and pleasurable activity  Ability to understand English, Punjabi, Urdu, Hindi or Gujarati (others seen individually with translator)

6. Patient Pathway Introductory Talk Option to decline Individual Assessment PCS (4 weeks) PMP (8 weeks) Review after 4 weeks Review after 4 weeks & 6 months Maintenance Group One to one

7. Some Topics Covered in Group  Pacing  Exercise  Challenge negative thinking  Relaxation training  ADL’s  Goal setting

8. Outcomes – physical measures

9. Outcomes - mood

10. Outcomes – pain related appts

14. Summary  Clinically effective  Cost effective ( 60% pain-related appts)  No waiting list  Please use ICE system to refer to us.  Any questions? Simon Dupont Pain Management Greenacres Centre 01895-279049