Living well with chronic musculoskeletal pain

Conference:

SAPC ASM 2021 - virtual

Talk Code:

4E.7

Presenter:

Noureen Shivji

Twitter:

@noureenkaramali

Co-authors:

1. Carolyn Chew-Graham, 2. Hollie Birkinshaw, 3. Adam Geraghty, 1. Helen Johnson, 3. Paul Little, Michael Moore, Beth Stuart, 2. Tamar Pincus

Author institutions:

1. School of Medicine, Keele University, 2. Department of Psychology, Royal Holloway, University of London, 3. Faculty of Medicine, University of Southampton

Problem

Musculoskeletal pain impacts on people’s quality of life, and is a common problem brought by patients to primary care consultations. Symptoms such as feeling low, lacking motivation, and struggling to maintain relationships are commonly reported by people with chronic musculoskeletal pain and maybe labelled as depression by general practitioners. Evidence suggests that the distress experienced in relation to living with chronic pain is different from ‘clinical’ depression. Although symptoms may appear identical, the underlying causes are qualitatively different. Current interventions and referral pathways may be suboptimal for patients with pain-related distress. Specifically, antidepressants are unlikely to be effective and there is a lack of patient-centered interventions available to patients and clinicians. The De-STRESS study aims to develop a patient-centered intervention for people with chronic musculoskeletal pain and pain-related distress.

Approach

University ethical approval obtained. A qualitative study utilising semi-structured interviews with GPs and people with pain to explore and understand: pain-related distress and how it differs from depression; how GPs currently manage people with chronic musculoskeletal pain and distress; and which interventions are considered useful and acceptable. We are using a range of recruitment methods including social media, local radio, local advertising. A patient advisory group has contributed to all aspects of the study so far.

Findings

Analysis of the data will be used to develop a framework to understand the identification and management of pain-related distress in primary care. We will present initial findings from our analysis, focussing on strategies people use to live with pain, the expectations of primary care services for support, improving access to support groups, and commissioning of more acceptable ‘talking therapies’. We will also present learning from our varied recruitment strategies for our study and more general lessons for primary care research.

Consequences

The findings from the De-STRESS study will contribute to the improvement of the care and support for people with chronic musculoskeletal pain, to help them live well, with their pain; to help GPs manage people with pain and distress in clinical practice, and influential to guideline developers focussed on pain and wellbeing. The value of using a variety of recruitment strategies will be emphasised.

Submitted by:

Noureen Shivji

Funding acknowledgement:

We would like to acknowledge Versus Arthritis for funding the De-STRESS pain study.