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Outcomes of a veteran-specific pain management programme by remote technology-based delivery: An observational study
Jannie Van Der Merwe1, Suzanne Brook2, Claire Fear2
1Centre of Veterans' Health, King Edward VII's Hospital, Marylebone, London.
Introduction:
A residential pain management programme for military veterans with high medical and psychological comorbidity was adapted for remote delivery. This study evaluates the outcomes of the remote technology-delivered pain management programmes (rPMP).
Methods:
Veterans with chronic pain, referred to a pain management programme, were assessed using online video calling. Veterans were suitable if they had chronic pain that affected their quality of life. Veterans were referred elsewhere when their needs were not best met by the programme. Eligible veterans attended a 9-day interactive online interdisciplinary programme and a 9-month follow-up. An experienced team of a psychologist, physiotherapist, nurse, and medical consultant, delivered the programme. Pain, mood, self-efficacy, and medication were assessed at the beginning and end of the programme and at 9-month follow-up.
Results:
107 veterans were treated in 16 rPMPs; results are from 92 complete sets of data. Statistically significant gains were observed from day 1 to day 9 (effect size Cohen's d): average pain d = 0.71, pain interference d = 0.82; mood, d = 0.99; self-efficacy, d = 0.85; reduction in catastrophic thinking, d = 1.22; overall health, d = 0.52; and changes in medication use. 72 veterans attended 9-month follow-up online; results are from 59 complete sets of data. Statistically significant gains were maintained at 9-month follow-up, effect size: mood, d = 0.71; self-efficacy, d = 0.80; reduction in catastrophic thinking, d = 0.95; and overall health, d = 0.52. Attendance was 97%, with positive feedback on programme content and delivery.
Conclusions:
Veterans made significant improvements on all outcomes. Remote technology-delivered pain management for veterans with chronic pain appeared equally effective as in-person delivery, and suited veterans whose circumstances made it difficult to attend in-person treatment. Veterans who attended the 9-month follow-up largely maintained treatment gains.
