P176 Meeting the demands of employment: the impact and rehabilitation of chronic pain and fatigue in the UK armed forces

Abstract

Background/AimsThe growing prevalence of chronic pain and the recent influx of post-viral fatigue (due to COVID-19) will limit the working output of the UK population. As such presentations become more common, the ability of the working population to meet the demands of their employment will depend on the effective management of chronic pain and fatigue.We investigated the working ability and outcomes of UK military personnel two years after rehabilitation for persistent pain or fatigue.MethodsWe collected the health data of 35 personnel presenting with primary persistent pain, fibromyalgia, or persistent fatigue during admission to the 2-week Specialist Rehabilitation Course at DMRC between November 2018 to December 2019. Participants scored their current ability to work and the work-related impact of their symptoms by completing a follow-up survey. This group also evaluated the efficacy of 14 evidence-based rehabilitation tools provided during their rehabilitation programme based on how they improved their ability to work.Results88.2% of attendees had a history of mental health issues, whilst 82.4% had other medical comorbidities. Royal Air Force (RAF) personnel predominantly presented with fatigue rather than pain; this subgroup left the armed forces two years earlier than the service average. 62.9% of attendees responded to our survey. 63.6% of respondents no longer served in the military two years after their initial admission to the rehabilitation course. All current military personnel reported either “good” or “very good” symptom management and as a cohort reported better work outcomes than those who had left the military. Respondents reported mindfulness, activity pacing and education about symptoms as the most effective strategies for improving work capability. Those who found these strategies most useful had the best outcomes. 7 of the 8 retained military personnel found at least two of these strategies useful for improving their work ability compared to 4 of the 14 military leavers.ConclusionPoor working ability due to persistent pain or fatigue was not compatible with sustained military employment. Yet, the tools provided at DMRC improved the ability to work for those remaining in the military. Military personnel with persistent pain and fatigue benefitted most from mindfulness, activity pacing and education. Response to these specific strategies corresponded with both continued military service and better work capabilities. These findings are consistent with the recent literature regarding the efficacy of these rehabilitation strategies for persistent pain and fatigue. The occupational outcomes of military personnel in this study may be comparable to that of civilian populations; specifically sectors with similar demands or mental health risks as the armed forces.Disclosure E. Chisala: None. S. Bahadur: None.