Transcript Document

PAIN MANAGEMENT PROGRAMME
HILLINGDON HOSPITAL
AIMS OF PRESENTATION:
PROVIDE AN OVERVIEW OF THE PAIN MANAGEMENT
PROGRAMME.
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SHOW OUTCOME INFORMATION
Simon Dupont
Pain Management Programme
Greenacres Centre
The Pain Management Programme
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Multidisciplinary Service
Clinical Psychologist
Occupational Therapist
Physiotherapist
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Two programmes targeting different patient groups.
NICE recommended (2009)
Low back / musculoskeletal pain >6 weeks
The Programmes
8 WEEK PAIN MANAGEMENT
PROGRAMME (PMP)
4 WEEK PAIN COPING
STRATEGIES (PCS)
Referrals accepted to either programme from
• GP’s – either ICE or paper
• Consultants
• Physiotherapists
• Extended Scope Practitioners
• Specialist Nurses
• Occupational Therapists
The Pain Management Approach
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Group format using a Cognitive Behavioural (CBT) model.
Takes into account the multisystem impact of pain
(physical, functional and emotional aspects).
Attempts to develop acceptance and ability to live with
pain using effective coping strategies.
Desired outcome: to increase activity despite pain.
Not to cure.
Prompts for Referral
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Chronic pain with a reduced sense of control over life
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Loss of self confidence
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Some degree of mood disturbance
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Unhelpful beliefs about pain (e.g. catastrophizing)
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Loss of quality of life
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Reduced activity levels
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Decreased levels of social and pleasurable activity
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Ability to understand English, Punjabi, Urdu, Hindi or
Gujarati (others seen individually with translator)
Patient Pathway
Introductory Talk
Option to decline
Individual Assessment
One to one
PCS (4 weeks)
Review after 4 weeks
PMP (8 weeks)
Review after 4 weeks & 6
months
Maintenance Group
Some Topics Covered in Group
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Pacing
Exercise
Challenge negative thinking
Relaxation training
ADL’s
Goal setting
Outcomes – physical measures
20
15
10
5
0
3 min walk
Sit to Stand
Pre
Post
Flexion
Outcomes - mood
12
10
8
6
4
2
0
Depression
Anxiety
Pre
Post
Outcomes – pain related appts
Anaes, Ortho & Rheum appts
Pain related appointments
100
80
60
40
20
0
PCS - 60 patients
6 months before attending group
PMP - 30 patients
6 months after attending group
Summary
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Clinically effective
Cost effective (60% pain-related appts)
No waiting list
Please use ICE system to refer to us.
Any questions?
Simon Dupont
Pain Management
Greenacres Centre
01895-279049