Barriers to Self-Management of Chronic Pain in Primary Care. Katy Gordon

Transcription

1 Barriers to Self-Management of Chronic Pain in Primary Care Katy Gordon K. Gordon 1, H. Rice 2, N. Allcock 3, P. Bell 4, M. Dunbar 5, S. Gilbert 6, H. Wallace 1 1. Pain Concern 2. Work4Me 3. Glasgow Caledonian University 4. Pain Alliance of Northern Ireland 5. NHS Greater Glasgow and Clyde 6. NHS Fife

2 Produce Informa.on Provide Support Research and Campaigning

3 Barriers to Self-Management of Chronic Pain in Primary Care Phase 1: What are the barriers? Research project: Why? How? What? Phase 2: What can we do about them? Increase awareness Share some resources to help

4 Why did we undertake the research? Benefits of successful selfmanagement Gaun Yersel the self-management strategy SIGN Guidelines Audit of pain services Anecdotal evidence of frustrarons and difficulres of selfmanagement for people in pain

5 Project Aims To ascertain the opinions of primary care healthcare providers on possible barriers to the facilita.on of self-management within their role. To ascertain opinions of people in chronic pain of possible barriers to the facilita.on of self-management based on their experience of primary care. DefiniRon of key terms Self-Management Pa.ents A single approach or combina.on of approaches that can be ini.ally taught by any health professional or learned by an individual to enable them to minimise the impact their chronic pain can have on everyday life 5 People with chronic pain and their carers.

6 What did we do? Who No. of parrcipants People with chronic pain 54 Carers 9 GPs 16 Physiotherapists 15 Occupa.onal Therapist 4 Prac.ce Nurses 2 Community Pharmacist 1 Total 101 Table 1: Par+cipant Breakdown Where NHS Healthboard No of groups Lothian 5 GG&C 5 Fife 3 Highland 2 Dumfries & Galloway Forth Valley 1 Tayside 1 Total 18 Table 2: Loca+on and number of focus groups by NHS Healthboard. 1

7 What did we find? Possible barriers to self-management of chronic pain in primary care PaRent/ HCP ConsultaRon PaRent Experience Limited Treatment OpRons OrganisaRonal Constraints

8 Possible barriers to self-management of chronic pain in primary care PaRent Experience Limited Treatment OpRons OrganisaRonal Constraints PaRent/ HCP ConsultaRon Timing of the self-management discussion CommunicaRon HCP/ parent relarons

9 Possible barriers to self-management of chronic pain in primary care PaRent Experience Limited Treatment OpRons OrganisaRonal Constraints PaRent/ HCP ConsultaRon I was at physiotherapy... they said, describe your pain. And I says, ten. Och, they laughed at me! Och, don t be silly! Describe your pain, what number is it? [Pa.ent] I think unless you are in chronic pain you don t know what they feel. And it is very difficult to relate to them. I think that s what I find quite difficult to understand [GP]

10 Possible barriers to self-management of chronic pain in primary care PaRent/HCP consultaron PaRent Experience Limited Treatment OpRons OrganisaRonal Constraints PaRent well being Long and inconclusive parent journey Ability/ Readiness to self-manage

11 Possible barriers to self-management of chronic pain in primary care PaRent/HCP consultaron Limited Treatment OpRons OrganisaRonal Constraints PaRent Experience that s what can make the whole self-management thing so difficult to s.ck to wan.ng to be your old self [Pa.ent] I think that that is probably the challenge, when they are stuck at the point of looking for a diagnosis and you are spending all your.me and energy on that. [GP]

12 Possible barriers to self-management of chronic pain in primary care PaRent/HCP consultaron PaRent Experience Limited Treatment OpRons OrganisaRonal Constraints MedicalisaRon Third Sector Support Training

13 Possible barriers to self-management of chronic pain in primary care PaRent/HCP consultaron PaRent Experience OrganisaRonal Constraints Limited Treatment OpRons at medical school it s [ ] here is a problem, there is a solu.on. And the solu.ons most.mes are to do with giving pa.ents prescrip.ons. [GP] So those kind of soger things, like community ac.vity groups could be hugely helpful, but they're much less easy to.ck boxes and to audit. [GP]

14 Possible barriers to self-management of chronic pain in primary care PaRent/HCP consultaron PaRent Experience Limited treatment oprons Appointment DuraRon WaiRng Lists Consistency and conrnuity of care OrganisaRonal Constraints

15 Possible barriers to self-management of chronic pain in primary care PaRent/HCP consultaron PaRent Experience Limited treatment oprons we are in a spiral at the minute that that is the only thing we can do in ten minutes - let s give you a prescrip.on. [GP] OrganisaRonal Constraints Well you re not treated holis.cally. You re hacked off into bits and separated out into separate parts of the NHS and one part deals with one part and another part deals with another part [Pa.ent]

16 Barriers to Self-Management of Chronic Pain in Primary Care Phase 1: What are the barriers? Research project: Why? How? What? Phase 2: What can we do about them? Increase awareness Share some resources to help

17 Barrier Breakers

18 Barrier Breakers 1. The project Breaking the barriers to selfmanagement 2. What is selfmanagement? 3. EmoRonal impact of chronic pain 4. GP consultarons 5. Medical invesrgarons 6. Pain management programmes

19 What is self-management video

20 Using the Resources Thank you, just the reminder I needed on a very bad day Thank for this informa.ve group of videos. They have helped me to understand that others feel the same as I do and their stories inspired me.

21 What s next Suppor.ng Self-Management in chronic pain: a collabora.ve approach providing relevant tools to healthcare professionals and people with pain research@painconcern.org.uk

22 Acknowledgements and References Funders Health and Social Care Alliance Edinburgh and Lothians Health FoundaRon References 1. SIGN Management of chronic pain: A na.onal clinical guideline. [online] Available at: hlp:// 2. Healthcare Improvement Scotland Chronic pain services in Scotland: Where are we now? [online] Available at: hlp:// 3. Health and Social Care Alliance Self-Management. [online]. Available at: hlp:// 4. Long Term Condi.ons Alliance Scotland GaunYersel: The Self-Management Strategy for Long Term Condi+ons in Scotland [online]. Available at: hlp:// [Accessed Feb ] 5. Boyers, D., McNamee, P., Clarke, A., Jones, D., Mar.n, D., Schofield, P. and Smith, B Cost-effec.veness of Self-management Methods for the Treatment of Chronic Pain in an Aging Adult Popula.on A Systema.c Review of the Literature. Clin J Pain. 29:4. Pg Jerant, A., Friederichs-Fitzwater, M., Moore, M. (2005). Pa.ents perceived barriers to ac.ve self-management of chronic condi.ons. Pa+ent Educ Couns 57, Bair, M., Malhias, M., Nyland, K., Huffman, M., Stubbs, D., Kroenke, K., Damush, T. (2009). Barriers and Facilitators to Chronic Pain Self-Management: A Qualita.ve Study of Primary Care Pa.ents with Comorbid Musculoskeletal Pain and Depression. Pain Med 10, Blakeman, T., Macdonald, W., Bower, P., Gately, C., Chew-Graham, C. (2006). A qualita.ve study of GPs avtudes to self-management of chronic disease. Br J Gen Pract 56,