AB1117-HPR Evaluation of Patient Reported Outcome Data Following Persistent Musculoskeletal Pain Service Redesign: Table 1
Authors: H. Light, J. Firth, K. Kinsey
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Persistent musculoskeletal pain (lasting &gt;3 months) is common in the UK and Europe. Following an independent review of service provision, a person-centred, integrated pathway of bio-psychosocial care was commissioned in Oldham, UK. A stepped care model was introduced comprising a single point of access to multidisciplinary care including psychological medicine, prescribing advice and exercise classes. <h3>Objectives</h3> To evaluate improvements in pain reported by patient and clinicians discharged from the service and compliance with data capture in the first 6 months. <h3>Methods</h3> Outcome data was collected on all patients opting in between 1st June-30th November 2015 including Pain Self-Efficacy Questionnaire (PSEQ) and DoloTest scores on entry and discharge and Clinical Global Impression-Improvement scale (CGI-I) on discharge. PSEQ scores range from 0–60; lower scores reflect little/ no confidence in performing daily activities. DoloTest scores range from 0–800 with lower scores reflecting a lower impact on quality of life. CGI-I is a clinician assessment of patient improvement, scores range from 1–7, with low scores reflecting an improvement and high scores reflecting deterioration. <h3>Results</h3> 369 patients opted in throughout the 6 month period, of which 170 (46%) have been discharged. Mean PSEQ score on entry was 17.3 (n=163), which improved to 30.7 (n=50) on discharge. 86% had an improvement in their PSEQ scores with 60% benefiting from a clinically significant improvement. The mean improvement was a score of 17, the mean improvement of significantly improved patients was 22.2 points. Mean DoloTest score on entry was 546.5 and 431.3 on discharge. 70% had an improvement in their DoloTest results; mean improvement was 154 points. There is no available benchmark for a clinically significant improvement for DoloTest. 72% of patients assessed using CGI-I were scored as having very much or much improved. 59 patients (35%) had missing discharge data. Reasons included patients failing to attend follow ups or opting out (46%), stepping up care up to secondary care provision for patients with complex needs (25%), and missing data, unknown (29%). 13 (8%) patients were discharged at first appointment therefore no follow up assessments were completed. <h3>Conclusions</h3> In all assessments, the majority of patients improved throughout their treatment. A change in PSEQ score around 10 is considered clinically significant. Of 7 patients with no improvement in PSEQ score, 2 scored &lt;20 indicating their focus on pain could influence their willingness to engage in activity. Of the remaining 5 patients, 3 had high initial scores (&gt;40) thought to be incongruent with requiring a pain management programme. Missing data affected the evaluation and qualitative work is being undertaken to understand the reasons for this and to inform strategies to increase data capture. <h3>Disclosure of Interest</h3> None declared