Chronic pain management : pain management programme versus invasive procedures

Abstract

Overview of the topic: The Pain Management Programme (PMP) consists of a multidisciplinary approach to assess and improve the patient’s quality of life, despite the pain present and work towards the relief of pain (Gauntlett-Gilbert & Brook, 2018). The ability of the PMP is to build up coping strategies to help people control and reduce their pain. The pain management programme is compared to typical orthopaedic invasive procedures that are thought to aid in chronic pain relief. Research question: Is the pain management programme an effective primary approach to chronic pain when compared to invasive procedures? PICO elements: The population (P) adults with orthopaedic chronic pain representing an age of 18years or older. The intervention (I) consisting of a multidisciplinary approach to assess and improve the patient’s quality of life working towards the relief of pain. The comparison (C) intervention was invasive/ interventional procedures. The expected outcome (O) improved pain relief with regards to the chronic pain management programme. Methods: The key elements of the PICO question were used as key terms to generate various alternative search terms. The adopted terms were combined using Boolean Operators to expand the search and narrowed down through the use of limiters by utilising inclusion and exclusion criteria. The joint terms were searched in three primary databases; PubMed, Hydi and EBSCO. The PRISMA 2020 checklist was the main framework used to screen articles. The Critical Appraisal Skills Programme (CASP) tools were used to critically appraise the literature. Any ethical matters were taken into consideration. Results: A total of five key studies were identified, one systematic review and four randomised controlled trials. Results showed no statistically significant improvements of patients undergoing surgical interventions compared to non-surgical therapy. A significant improvement in secondary outcomes with regards to the PMP involving work status and pain medication use, was observed. Implications and recommendations: It is recommended to provide pain management education to all chronic pain patients. The integration of the PMP into routine clinical work will require the training of medical staff and their awareness of its importance. Additional financial resources and personnel will have to be allocated to improve on the PMP currently available.