PAIN+ CPN

Doctor, I have chronic pain. Will a patient-led Chronic Pain Self-Management Programme help me manage my symptoms?

The patient-led version of the Chronic Pain Self-Management Programme did not have an impact on pain, function, or other symptoms compared with treatment as usual when implemented in Denmark. It also did not lead to any reduced health care costs.


What is the evidence?

Researchers looked at patients who participated in a patient-led self-management programme and compared them to patients who received treatment as usual. They measured pain, disability, self-efficacy, illness worry, emotional distress, and health care costs at 3 months. They found that:

  • There was no difference for pain or disability between patients in the self-management program and those who received treatment as usual
  • Patients in the self-management program worried less about their illness and had less emotional distress
  • There was no difference in health care costs between the two groups
  • Some patients felt that the patient leaders of the program did not have enough expertise to run the program
  • This study took place in Denmark, and the results may not apply to other countries

What kind of study was this?

This was a randomized controlled trial RCT. In an RCT, patients are randomly assigned to receive the treatment under study or a comparator treatment.

Who participated in the study? This study included 424 people from Denmark who had chronic pain for at least 3 months.

How was the study done? The study compared a patient-led version of the Stanford Chronic Pain Self-Management Programme with treatment as usual. Patients were followed up after the programme was finished, and 3 months later.

Chronic Pain Self-Management Programme

vs

Treatment as usual

This programme consists of six 2.5-hour weekly workshops on how to manage pain during daily life. The workshops were held with groups of 8-16 people with chronic pain. It was facilitated by two workshop leaders, and at least 1 of these leaders has a long-term pain condition. Themes include managing feelings, fatigue, social isolation, poor sleep quality, improving strength, correct use of medication, and new treatment possibilities. Sessions includes lectures and exercises in physical activity, visualization, relaxation, and communication. Participants develop weekly action plans and share their experiences with their group. 



Patients assigned to the treatment as usual arm could continue with any treatment they were already receiving and could be offered new therapies. However, they were not able to join the Chronic Pain Self-Management Programme during the 5 months the trial took place.



Why was this research done?

Pain self-management programs can be accessible and affordable interventions for people who have chronic pain conditions. Self-management programs that are led by health care professionals have been shown to be effective, and programs led by patients may also be effective. The Chronic Pain Self-Management Programme has shown some effectiveness in earlier studies but needs more research to find out if it works.

This Evidence Summary is based on the following article:

Mehlsen M, Hegaard L, Ornbol E, et al. The effect of a lay-led, group-based self-management program for patients with chronic pain: a randomized controlled trial of the Danish version of the Chronic Pain Self-Management Programme. Pain. 2017 Aug;158(8):1437-1445. doi: 10.1097/j.pain.0000000000000931. PubMed

Published: Friday, December 21, 2018