Eur J Pain. 2021 Jul 9. doi: 10.1002/ejp.1836. Online ahead of print.
ABSTRACT
BACKGROUND: Chronic pain is a significant health problem worldwide and requires a biopsychosocial treatment approach. Access to traditional pain medicine specialist services is limited and innovative treatment models are required to support patients in tertiary care. The study evaluated the clinical effectiveness and safety of the Treatment Access Pathway (TAP), an allied health expanded scope model of care which included innovative group assessment and collaboration with patients to create individualised treatment plans.
METHODS: One hundred and eighty-one patients referred to a tertiary level chronic pain service were randomly allocated to either the TAP or the waitlist study groups. Primary (pain interference) and secondary outcome measures were collected at recruitment and again at 6 months. Per-protocol analyses were utilised due to high participant attrition (46% across groups).
RESULTS: The TAP group reported greater reductions in pain interference at 6-months than waitlist group (0.9, 95% CI: 0.2 to 1.6), with more than half of the TAP group (52%) reporting clinically significant improvement. In addition, statistically significant differences between the TAP and waitlist groups were observed for objective measurements of walking endurance (5.4 meters, 95% CI: 1.7 to 9.1); and global impressions of change (1.4 unit decrease, 95% CI: 1 to 1.9). Nil adverse events were recorded.
CONCLUSIONS: The study suggests that an expanded scope allied health model of care prioritising patient choice and group-based interventions, provides modest benefits for tertiary-referral chronic pain patients. TAP warrants further investigation as a potentially viable alternative for tertiary healthcare where traditional pain services are unavailable or have long waiting lists.
PMID:34242463 | DOI:10.1002/ejp.1836
