A Regional Program Evaluation of the Stanford Chronic Pain Self-Management Program in Eastern Ontario, Canada

Overview

Journal Can J Pain

Date 2025 Jan 31

PMID 39886609

Authors

E Hum

S Karunananthan

A Adil

I Moroz

R Davidson

C Liddy

Affiliations

Soon will be listed here.

Abstract

Background: Health care providers often struggle to treat patients with chronic pain. One potential solution is to facilitate access to programs and tools that develop patients' skills and confidence in managing their own care.

Aims: This study aimed to describe the uptake of the Chronic Pain Self-Management Program (CPSMP) in Eastern Ontario and evaluate the effectiveness of the program in the acquisition of knowledge, confidence, and skills required to manage chronic pain, as measured by the Patient Activation Measure (PAM).

Methods: Using data routinely collected through the CPSMP between December 2017 and May 2023, we conducted a descriptive analysis of the number of participants each year, their gender, and their age distributions. We conducted a longitudinal analysis of the change in PAM score between participants' first (baseline) and last (follow-up) day in the program.

Results: Overall, 1023 individuals enrolled in the CPSMP during the study period, with enrollments peaking in 2018 and remaining stable thereafter. There was a higher proportion of females compared to males (69%, = 709) and 50- to 59-year-olds compared to other ages. Of the 1023 participants enrolled, 151 completed PAM surveys at baseline and follow-up (15%), of which 69% experienced an increase of at least 4 points on the PAM (104/151).

Conclusion: Most participants were female and aged 50 to 59 years old. Among a sample of participants with available longitudinal data, the CPSMP demonstrated promising effectiveness at equipping participants with the knowledge, skills, and confidence to manage their pain. Replication in a larger representative sample is warranted.

References

Hestmann R, Bratas O, Gronning K . Chronic pain self-management interventions in primary care - does it make any difference? A qualitative study. BMC Health Serv Res. 2023; 23(1):537. PMC: 10210462. DOI: 10.1186/s12913-023-09548-8. View

Hosseinzadeh H, Verma I, Gopaldasani V . Patient activation and Type 2 diabetes mellitus self-management: a systematic review and meta-analysis. Aust J Prim Health. 2020; 26(6):431-442. DOI: 10.1071/PY19204. View

Young L, Hertzog M, Barnason S . Effects of a home-based activation intervention on self-management adherence and readmission in rural heart failure patients: the PATCH randomized controlled trial. BMC Cardiovasc Disord. 2016; 16(1):176. PMC: 5016888. DOI: 10.1186/s12872-016-0339-7. View

Upshur C, Luckmann R, Savageau J . Primary care provider concerns about management of chronic pain in community clinic populations. J Gen Intern Med. 2006; 21(6):652-5. PMC: 1924617. DOI: 10.1111/j.1525-1497.2006.00412.x. View

Liddy C, Johnston S, Guilcher S, Irving H, Hogel M, Jaglal S . Impact of a chronic disease self-management program on healthcare utilization in eastern Ontario, Canada. Prev Med Rep. 2016; 2:586-90. PMC: 4721386. DOI: 10.1016/j.pmedr.2015.07.001. View

Gleason K, Tanner E, Boyd C, Saczynski J, Szanton S . Factors associated with patient activation in an older adult population with functional difficulties. Patient Educ Couns. 2016; 99(8):1421-6. PMC: 4931946. DOI: 10.1016/j.pec.2016.03.011. View

Choiniere M, Dion D, Peng P, Banner R, Barton P, Boulanger A . The Canadian STOP-PAIN project - Part 1: Who are the patients on the waitlists of multidisciplinary pain treatment facilities?. Can J Anaesth. 2010; 57(6):539-48. DOI: 10.1007/s12630-010-9305-5. View

Blyth F, March L, Nicholas M, Cousins M . Self-management of chronic pain: a population-based study. Pain. 2005; 113(3):285-292. DOI: 10.1016/j.pain.2004.12.004. View

Dorn S, Palsson O, Woldeghebriel M, Fowler B, McCoy R, Weinberger M . Development and pilot testing of an integrated, web-based self-management program for irritable bowel syndrome (IBS). Neurogastroenterol Motil. 2014; 27(1):128-34. PMC: 5317252. DOI: 10.1111/nmo.12487. View

10.

Lorig K . Chronic disease self-management program: insights from the eye of the storm. Front Public Health. 2015; 2:253. PMC: 4410327. DOI: 10.3389/fpubh.2014.00253. View

11.

Ory M, Smith M, Ahn S, Jiang L, Lorig K, Whitelaw N . National study of chronic disease self-management: age comparison of outcome findings. Health Educ Behav. 2014; 41(1 Suppl):34S-42S. DOI: 10.1177/1090198114543008. View

12.

Hibbard J, Greene J . What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff (Millwood). 2013; 32(2):207-14. DOI: 10.1377/hlthaff.2012.1061. View

13.

Pullyblank K, Brunner W, Scribani M, Krupa N, Wyckoff L, Strogatz D . Evaluation of a Peer Led Chronic Pain Self-Management Program in a Rural Population. J Prim Care Community Health. 2022; 13:21501319221121464. PMC: 9476237. DOI: 10.1177/21501319221121464. View

14.

Gomaa S, Posey J, Bashir B, Basu Mallick A, Vanderklok E, Schnoll M . Feasibility of a Text Messaging-Integrated and Chatbot-Interfaced Self-Management Program for Symptom Control in Patients With Gastrointestinal Cancer Undergoing Chemotherapy: Pilot Mixed Methods Study. JMIR Form Res. 2023; 7:e46128. PMC: 10674151. DOI: 10.2196/46128. View

15.

Hevey D, Wilson ORaghallaigh J, ODoherty V, Lonergan K . Pre-post effectiveness evaluation of Chronic Disease Self-Management Program (CDSMP) participation on health, well-being and health service utilization. Chronic Illn. 2018; 16(2):146-158. DOI: 10.1177/1742395318792063. View

16.

Mehlsen M, Heegaard L, Frostholm L . A prospective evaluation of the Chronic Pain Self-Management Programme in a Danish population of chronic pain patients. Patient Educ Couns. 2015; 98(5):677-80. DOI: 10.1016/j.pec.2015.01.008. View

17.

Hibbard J, Stockard J, Mahoney E, Tusler M . Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004; 39(4 Pt 1):1005-26. PMC: 1361049. DOI: 10.1111/j.1475-6773.2004.00269.x. View

18.

Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D . Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2005; 10(4):287-333. DOI: 10.1016/j.ejpain.2005.06.009. View

19.

Lorig K, Ritter P, Laurent D, Plant K . Internet-based chronic disease self-management: a randomized trial. Med Care. 2006; 44(11):964-71. DOI: 10.1097/01.mlr.0000233678.80203.c1. View

20.

Hanewinkel R, Wiborg G . Initial evaluation of a real-world self-help smoking cessation programme for adolescents and young adults. Addict Behav. 2006; 31(10):1939-45. DOI: 10.1016/j.addbeh.2005.12.022. View