Developing a psychologically-informed pain management course for use in osteopathic practice: The OsteoMAP cohort study

Abstract

BackgroundMultidisciplinary healthcare programmes which include psychosocial interventions for persistent musculoskeletal pain demonstrate better patient outcomes than separate physical therapies. This paper reports outcomes from the OsteoMAP study, which combined psychological and mindfulness-informed interventions from Acceptance and Commitment Therapy (ACT) with manual treatment to create a multimodal pain self-management course for delivery by osteopaths working with patients with long-term musculoskeletal conditions. MethodA single cohort of 256 patients participated in a new persistent pain self-management course. Self-report data was collected at baseline (n = 180) and after six months (n = 79) using the European Quality of Life, Bournemouth and Revised Action and Acceptance Questionnaires and the Freiburg Mindfulness Inventory. ResultsThere were significant improvements in all four outcome measures (p < 0.001). Changes in quality of life and coping with pain showed significant correlations with increased psychological flexibility (r = 0.69–0.71) and slightly weaker associations with mindfulness (r = 0.50–0.51). ConclusionsThis psychologically-informed self-management course was feasible for delivery in an osteopathic educational clinic and patient outcomes supported proof of concept. A pragmatic randomised controlled trial is now recommended to compare course effects with other management approaches and to continue developing multimodal care for patients with persistent pain presenting in general osteopathic practice.