Evaluating a person-centred chronic pain service using indices of reliable and clinically significant change

Macey, Katherine; Clarke, Simon; Golijani-Moghaddam, Nima; Das Nair, Roshan

Abstract

Background: Psychological interventions for chronic pain often require substantial individualisation, which can undermine links with the research evidence on which treatment is based. To ensure patients receive effective therapy, evaluation is needed. This paper demonstrates the use of individual level change indices, which may be more appropriate for assessing effectiveness of person-centred treatment than traditional group-level statistics.

Aims: To evaluate the efficacy of a psychological chronic pain service at individual level and to recommend improvements for future service evaluation.

Method: Indices of reliable and clinically significant change were used to assess outcomes on the HADS, CORE-10 and PSEQ.

Results: Fifty-six out of 83 patients had usable outcome data. On the most widely administered outcome measure, the CORE-10, n=15 met reliable change and n=22 met clinically significant change criteria. Eighteen showed no reliable change. Only one person deteriorated.

Conclusions: The person-centred treatment provided by this service was effective and achieved outcomes similar to published data from a structured group programme. However, missing data reduced the reliability of these conclusions and led to reduced usefulness of the evaluation for service planning. Recommendations for future evaluation are made.

Citation

Macey, K., Clarke, S., Golijani-Moghaddam, N., & Das Nair, R. (2015). Evaluating a person-centred chronic pain service using indices of reliable and clinically significant change. European journal for person centered healthcare, 3(1), 19. https://doi.org/10.5750/ejpch.v3i1.855

• Journal Article Type: Article
• Acceptance Date: Mar 21, 2014
• Online Publication Date: Feb 11, 2015
• Publication Date: Mar 1, 2015
• Deposit Date: Jun 15, 2016
• Publicly Available Date: Jun 15, 2016
• Journal: European Journal for Person Centered Healthcare
• Electronic ISSN: 2052-5656
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 1
• Pages: 19
• DOI: https://doi.org/10.5750/ejpch.v3i1.855
• Keywords: Audit, Chronic pain, Evidence-based practice, Outcome measures, Patient choice, Patient experience, Person-centered healthcare, Practice-based evidence, Psychology services, Service evaluation, Service effectiveness, Shared decision-making
• Public URL: https://nottingham-repository.worktribe.com/output/744061
• Publisher URL: http://www.ejpch.org/ejpch/article/view/855
• Contract Date: Jun 15, 2016