Short-term effect of a chronic pain self-management intervention delivered by an easily accessible primary healthcare service: a randomised controlled trial

Abstract

Abstract Objectives To investigate the effects on persons with chronic pain after 3 months of a group-based chronic pain self-management course compared with a drop-in, lowimpact outdoor physical group activity on patient activation and a range of secondary outcomes. Design An open, pragmatic, parallel group randomised controlled trial. Analyses were performed using a two-level linear mixed model. Setting An easily accessible healthcare service provided by Norwegian public primary healthcare. Participants A total of 121 participants with self-reported chronic pain for 3 months or more were randomised with 60 participants placed in the intervention group and 61 placed in the control group (mean age 53 years, 88% women, 63% pain for 10 years or more). Interventions The intervention group was offered a group-based chronic pain self-management course with 2.5-hour weekly sessions for a period of 6 weeks. The sessions consisted of education, movement exercises and emphasised group discussions. The control group was offered a low-impact outdoor group physical activity in 1-hour weekly sessions that consisted of walking and simple strength exercises for a period of 6 weeks. Main outcomes The primary outcome was patient activation assessed using the Patient Activation Measure. Secondary outcomes measured included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30 s chair to stand test. Results There was no effect after 3 months of the groupbased chronic pain self-management course compared with the control group for the primary outcome, patient activation (estimated mean difference: −0.5, 95% CI –4.8 to 3.7, p=0.802). Conclusions There was no support for the selfmanagement course having a better effect after 3 months than a low-impact outdoor physical activity offered the control group. Trial registration number NCT02531282; Results.