- Title
- Individual multidisciplinary assessment versus group assessment at an Australian tertiary multidisciplinary pain service: a randomised trial
- Creator
- Smith, Natalie
- Resource Type
- thesis
- Date
- 2015
- Description
- Professional Doctorate - Doctor of Clinical & Health Psychology (DClin&HealthPsych)
- Description
- Scope: The high prevalence of persistent pain and subsequent burden upon society demands effective and efficient interventions to manage persistent pain. Multidisciplinary pain clinics provide effective treatment in the management of pain. However, long wait-lists prevent timely access. Purpose: This study compared traditional individual multidisciplinary assessment with a new group assessment format. Method: Two-hundred and eleven chronic non-cancer pain patients referred to the Hunter Integrated Pain Service, NSW Australia were randomly assigned to either individual multidisciplinary assessment (a total of 3 hours of consecutive assessment with medical, psychology/psychiatry and physiotherapy staff) or group assessment (5 hours of guided self-assessment with medical, psychology, physiotherapy and nursing staff). Both options involved patient education and development of a pain management action plan. Follow-up occurred by telephone at 3 months post-assessment. Outcomes included pain self-efficacy, pain interference, pain intensity, psychological distress, patient satisfaction, level of confidence in implementing active self-management strategies, health care utilisation and wait-time from attendance at the pre-assessment education group to assessment. Results: Ninety patients attended individual multidisciplinary assessment and 72 patients attended the group assessment. Results demonstrated that outcomes were comparable between the two assessment formats in terms of pain self-efficacy, pain severity, pain interference, psychological distress and health care utilisation. Promising results regarding reduced health care utilisation were demonstrated, with the both groups significantly reducing GP visits by approximately 1.5 visits. Specialist appointments were also reduced. The two assessment formats were equally satisfied with their assessment (not satisfied/not unsatisfied), were equally confident in their ability to implement self-management strategies (not confident/not-unconfident) and implemented an equal amount of nominated strategies. Results from this study demonstrated that the wait time to assessment was significantly longer for the individual format. Patients accessing the more traditional delivery of service via multidisciplinary team assessment waited on average 144 days until first offer of assessment compared with 47 days for the group assessment. Conclusions: The group assessment can be considered as an acceptable first ‘step’ in a stepped-care approach and an acceptable alternative to the lengthy, resource intensive multidisciplinary assessment, which inhibits quick access to MPC’s. The one-off, brief group format allows patients to be seen within an earlier timeframe, without compromising quality or patient outcomes and provides the provision to access intensive programs earlier if required. The group assessment, with its self-management focus, commences to address the issue of high health care utilisation in the persistent pain population.
- Subject
- chronic pain; multidisciplinary; wait-time; self-management; assessment group
- Identifier
- http://hdl.handle.net/1959.13/1309907
- Identifier
- uon:21959
- Rights
- Copyright 2015 Natalie Smith
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Abstract | 238 KB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 2 MB | Adobe Acrobat PDF | View Details Download |