Development of two outpatient interdisciplinary group modules in the treatment of patients with pain and risk of chronification

Abstract

An early treatment of patients who suffer from pain and show risk factors for chronification is meaningful as these patients can benefit from an early interdisciplinary multimodal pain treatment (IMST). In view of the insufficient treatment, two outpatient treatment modules for the secondary prevention of pain chronification are developed within the framework of PAIN2020: the educative and accompanying IMST (E‑IMST and B‑IMST). The developmental process of both IMSTs is presented. In this context two target groups of patients were defined for which 1session (E‑IMST) or 10intervention appointments (B‑IMST) were planned, depending on the chronification, impairment and complexity of the disorder. The conception was carried out in five steps: development of the objectives, development of the main contents, workshop on the content and conceptional design (contents, mediation, exercises), preparation of atime schedule and processing of the results (manual, presentations, worksheets, handbook). The B‑IMST was initially developed from which the contents for the E‑IMST were subsequently extracted. Additionally, aconcept for testing the feasibility and aworking model for apilot study were developed. The objectives for both forms of IMST are improvement of the understanding of pain and contributing factors, the increase of the experience of control and self-efficacy and the increase in self-responsibility with respect to strategies to reduce pain. Differences between the two treatment modules arise from the needs and framework conditions. Medical, physiotherapeutic and psychotherapeutic contents and schedules were organized for both IMST modules. The B‑IMST consists of five modules each with two sessions as group interventions (biopsychosocial model, activation planning, regulation of needs, sleep and medication, routine transfer). The 3‑h E‑IMST group intervention mainly intends to mediate knowledge on pain and the biopsychosocial pain model. Theoretical and practical interventions, empirical knowledge and experience-oriented methods are employed. There are now two interdisciplinary structured manuals for the secondary preventive treatment of patients with recurrent pain and arisk profile for chronification. These approaches must now prove themselves with respect to feasibility and effectiveness.