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对英国国家医疗服务体系提供的由临床医生和患者共同主导的慢性肌肉骨骼疼痛自我管理项目的接受情况及其对患者报告结局的影响进行评估。

Evaluation of uptake and effect on patient-reported outcomes of a clinician and patient co-led chronic musculoskeletal pain self-management programme provided by the UK National Health Service.

作者信息

Anderson Joanna K, Wallace Louise M

机构信息

Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.

Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK.

出版信息

Br J Pain. 2018 May;12(2):104-112. doi: 10.1177/2049463717734015. Epub 2017 Sep 26.

Abstract

In the United Kingdom, chronic pain affects approximately 28 million adults, creating significant healthcare and socio-economic costs. The aim was to establish whether a programme designed to use best evidence of content and delivery will be used by patients with significant musculoskeletal pain problems. Of 528 patients recruited, 376 participated in a 7-week-long group-based self-management programme (SMP) co-delivered by clinical and lay tutors. Of these, 308 patients (mean age, 53 years; 69% females, 94% White) completed at least five SMP sessions. Six months after pre-course assessment, participants reported significantly improved patient activation and health status, lower depression and anxiety scores, decreased pain severity and interference, and improved self-management skills. There were no improvements in health state and pain self-efficacy. Uptake rate was 71% and completion 82%. The results should be of value to commissioners of pathways of care for the large numbers of patients attending the English NHS for chronic musculoskeletal pain.

摘要

在英国,慢性疼痛影响着约2800万成年人,产生了巨大的医疗保健和社会经济成本。目的是确定一项旨在运用内容和实施方面最佳证据的项目是否会被患有严重肌肉骨骼疼痛问题的患者采用。在招募的528名患者中,376名参与了由临床和非专业导师共同实施的为期7周的基于小组的自我管理项目(SMP)。其中,308名患者(平均年龄53岁;69%为女性,94%为白人)完成了至少五节SMP课程。在课前评估六个月后,参与者报告称患者的自我效能感和健康状况显著改善,抑郁和焦虑得分降低,疼痛严重程度和干扰减少,自我管理技能提高。健康状况和疼痛自我效能感没有改善。参与率为71%,完成率为82%。这些结果对于众多因慢性肌肉骨骼疼痛前往英国国民健康服务体系(NHS)就诊的患者的护理途径专员而言应该具有参考价值。

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