66 Hope in chronic pain: a model for lifestyle medicine group consultations in primary care

Résumé fourni par la source

Background Chronic pain is challenging to manage in primary care. However, secondary care services are oversubscribed, leaving patients and GPs struggling. There is emerging evidence that lifestyle medicine group consultations can help but research is limited. We adapted an existing programme and delivered group consultations to patients from a deprived primary care population.Methods Patients with chronic pain were invited to an introductory webinar. Interested patients then attended six face-to-face group consultations, with each focusing on a different aspect of lifestyle medicine and including chair yoga. Consultations were delivered by two GPs, with guest sessions by a person with lived experience of chronic pain and a secondary care chronic pain physiotherapist. Patients completed the Pain Self Efficacy Questionnaire (PSEQ) pre- and post-intervention. Analgesic medication use was reviewed at baseline and at seven months after enrolment. Five patients were interviewed and thematic analysis undertaken.Results Nineteen patients attended the first consultation (median age 61, range 29-83; 100% female). Patients attended a median of 5 consultations (range 3-6).Mean PSEQ scores improved by 7.6 points (standard deviation 10.6) out of 60. This represents a moderate to large within-subject effect size (Cohen’s dz = 0.72). At seven months, no patients had increased their analgesic use while nine patients had requested a reduction or stopped it entirely.Interviews revealed the following themes: reduced isolation, improved trust in GPs, reframing of pain, symptom improvement using practical tools, and reconsideration of the role of medication.The GPs reported increased confidence in managing chronic pain and felt that the consultations were some of their most enjoyable experiences as clinicians.Conclusions Lifestyle medicine group consultations delivered positive outcomes for patients and clinicians. The GP facilitators had no additional training in chronic pain, so this model could be easily emulated in other centres.

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