Background
Musculoskeletal disorders are a major health problem for both individuals and the healthcare system. As patients with musculoskeletal pain (MSKP) initially seek primary care it is important that this care is of high quality. New ways of helping patients manage their MSKP are needed due to an increasing demand for limited healthcare resources.
Previous research has reported that "Pain Science Education" (PSE) can help people with chronic pain manage their MSKP by increasing their knowledge and understanding. The PainSMART-project aims to evaluate whether PSE delivered early in primary care rehabilitation can contribute to a shared and broadened understanding of MSKP for patients and clinicians. Furthermore, it will evaluate whether highlighting the influence of physical, mental, lifestyle and environmental factors on MSKP can improve patients’ experience of pain and facilitate rehabilitation.
The PainSMART-project aims to develop and evaluate a PSE-strategy for patients seeking primary care for pain from muscles and joints. The project began (2021) by creating an educational strategy (the PainSMART-strategy) usable by patients and clinicians in primary care. The PainSMART-strategy is initiated whilst a patient is waiting for their initial healthcare consultation, i.e. prior to assessment and the start of rehabilitation. The project evaluates whether the PainSMART-strategy can enhance the start of rehabilitation for patients with MSKP.
Research studies
The following planned or ongoing research sub-studies will evaluate whether adding the PainSMART-strategy to usual physiotherapy treatment for patients with MSKP can significantly improve:
- Patient Reported Outcomes (PROMs)
- Process outcomes (e.g. sick leave, health care consumption)
- Patient and clinician Reported Experience Measures (PREMs)
Additional sub-studies will evaluate:
- Whether changes in patients’ perceptions of pain and the level of reassurance as to the benign nature of pain mediate the effect of the PainSMART-strategy on pain intensity and patients’ confidence in their ability to be active despite pain (self-efficacy).
- Which baseline factors can predict improved patient outcomes after exposure to the PainSMART-strategy and which factors predict persistence of MSKP.
- What type of coping strategies are associated with patient outcomes after exposure to the PainSMART-strategy.
- How or if exposure to the PainSMART-strategy influences communication about pain at the initial physiotherapy consultation (Qualitative research exploring and describing patients' and physiotherapists' communication).
