Potential Pain Management Programmes in primary care. A UK-wide questionnaire and Delphi survey of experts.
BACKGROUND
Most chronic pain patients are treated in primary care and their management is often challenging. Secondary care- or private sector-based Pain Management Programmes (PMPs) offering intensive multidisciplinary approaches have been found to improve participants' physical performance and psychological well-being.


OBJECTIVE
We aimed to identify the components and perceived outcomes of multidisciplinary PMPs in the UK and to explore expert health care providers' opinions about important characteristics of an ideal yet practical PMP for delivery in primary care.


METHODS
All PMPs in the UK (n = 77), identified through the British Pain Society, were invited to participate. Each PMP was sent a postal questionnaire. We then conducted a modified Delphi survey with 18 pain management experts from a range of professional backgrounds.


RESULTS
A representative from 54 (response rate 70.1%) PMPs completed a questionnaire. Most PMPs were delivered in National Health Service outpatient secondary care by physiotherapists (98%), psychologists (94%), pain specialists (61%), nurses (54%) and occupational therapists (52%). There was evidence of reasonably prolonged follow-up of participants and use of a range of clinical outcome measures. Consensus was reached on most components and outcomes of a potential primary care-based PMP. 'Necessary' components included training in, and information about, self-management, general fitness, posture and mobility. Input from a physiotherapist and clinical or health psychologist was identified as key to the PMP. Preferred patient outcome measures were related to emotional well-being, self-efficacy and coping and quality of life.


CONCLUSIONS
Future research should look to design, deliver and evaluate a primary care-based intervention based on these findings.
Aberdeen Pain Research Collaboration, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK. n.torrance@abdn.ac.uk
Nicola
N
Torrance
Blair H
BH
Smith
Alison M
AM
Elliott
Susan E
SE
Campbell
W Alastair
WA
Chambers
Philip C
PC
Hannaford
Marie
M
Johnston
D001291:Attitude of Health Personnel; D003697:Delphi Technique; D019538:Health Care Surveys / Q000379:methods; D006801:Humans; D059408:Pain Management; D011320:Primary Health Care / Q000379:methods*; D013222:State Medicine; D006113:United Kingdom