Developing a new approach to persistent pain management in osteopathic practice. Stage 1: A feasibility study for a group course

Abstract

BackgroundPersistent pain is a complex biopsychosocial problem which can be challenging to manage in clinical practice. This paper reports the first in a series of studies exploring ways to enhance care for patients with persistent pain using Acceptance and Commitment Therapy (ACT). In this study, six week 'Living Well with Persistent Pain' groups were co-facilitated by a clinical psychologist and an osteopath. MethodA mixed methods, repeated measures, observational design. Patients receiving osteopathic treatment were invited to 'opt-in' and attended screening interviews. Course content and structure were adapted from NHS pain services and open source ACT material. Data was collected from questionnaires at baseline, six weeks (end of course) and after three months, and semi-structured telephone interviews at three months. ResultsFifteen patients completed a group course. Thematic Analysis of transcripts indicated that participants considered the course was helpful. Questionnaire data at three month follow-up showed small but sustained improvements in mean scores for activity and pain acceptance: CPAQ Activity change −1.02 (SD 0.90), 95%CI -1.78 to −0.27; CPAQ Total change −0.78 (SD 0.87), 95%CI -1.51 to −0.05. ConclusionsFindings from this small feasibility study indicated that patient satisfaction with an ACT-based pain management group was high and questionnaires indicated improvements in activity and pain acceptance. However, individual responses varied widely and full data was obtained from only eight participants. Results were interpreted cautiously and used to inform the design of further studies exploring the process and effects of integrating ACT interventions directly with osteopathic care for individual patients.