E058 The effects of a pain management programme for patients with an inflammatory arthritis

Abstract

Abstract Background/Aims This study examines the benefits of Pain Management Programmes (PMPs) for patients with inflammatory arthritis who still report pain and fatigue despite optimal medical management. PMPs are widely recommended (e.g. NICE 2021) for people living with persistent pain, using cognitive behavioural therapy and acceptance and commitment therapy. Programmes aim to enable participants to develop self-management ways of living with their pain, so that pain interferes less in their lives and people feel more confident, and positive about the future. We developed a PMP for patients with an inflammatory rheumatological condition with the additional aim of helping participants to identify when they could self-manage their pain and when they needed healthcare to treat their condition and manage acute pain crises. Methods Patients were offered the programme in an information session, followed by assessment with a psychologist and physiotherapist where treatments options were discussed, among them the PMP. Selection criteria were: any type of inflammatory rheumatological condition and persistent pain diagnosed at least 18 months earlier and relatively stable in terms of current treatment; over the age of 18; and able to speak English. The programme ran for eight weekly, 5-hour sessions, with reviews at one and 9 months afterwards. Groups of between 3-11 patients were run in person by a multidisciplinary team of specialists from both outpatient pain management and rheumatology services. Between April 2016 and September 2020, 45 patients (8 men, 37 women) attended 6 programmes and 33 completed outcome measures on pain, disability and distress on the first and last day and at reviews. Results Post-treatment results showed significant improvement in confidence in managing pain, less interference of pain with everyday life, less fear, greater acceptance and a more positive outlook. Mood, pain intensity and relief from the pain did not change. Improvements gained post-treatment were sustained at one month and nine-months. The effect size of the improvements was medium or large. Conclusion This study shows that attending a PMP can improve quality of life for people with inflammatory arthritis even without reducing pain intensity. Across the programme, patients grew in confidence to engage in life alongside their pain; with significant changes sustained at nine months. However, follow-up outcomes were not returned by two thirds of those who completed the programme, in part due to the pandemic, making it hard to generalise to the wider population of patients. Disclosure K. Corcoran: None. I. Hung: None. R. Stovell: None. J. Manson: None. S. Moore: None. A. Soni: None. A. Williams: None.