The Development and Delivery of a Specialised Multidisciplinary Pain Management Group Programme for Women with Chronic Pelvic Pain

Background\nChronic Pelvic Pain (CPP) affects around one in five women. Despite high healthcare usage, management of CPP is often unsuccessful resulting in high levels of disability and costs to society. Despite recognition of parallels with other chronic pain syndromes, the management of CPP remains exclusively unimodal and biomedical.\nLocal unmet needs audits confirmed that the complexity of the presentations of many of these women necessitates multidisciplinary pain management treatment. There is currently limited access for these women to receive such treatment and the current economic climate requires that any new treatments are low cost.\nThe delivery of a pain management treatment within a group has multiple benefits including normalising the experience of pain, opportunities to draw on the experiences of group members, and lower delivery costs per case than individual treatment models.\n\nAims\nTo develop an effective group pain management intervention that reduces the impact of CPP on the lives of participants, and the burden of CPP on health resources.\n\nMethods\nInformed by the literature, and international programmes a small group pain management programme (PMP) was developed and delivered to four consecutive groups of women with CPP. Psychosocial correlates of pain were assessed prior to commencing the programme, at completion and three months later. A within subject, repeated measures design was used to investigate clinically significant change associated with pain related disability.\n\nResults\nTwenty-one women completed the programme and complete data for 16 participants were available for analysis.\nThree months following completion of the programme over 80% of the women reported a clinically significant improvement in both pain intensity and interference from pain. Sixty- seven percent reported a clinically significant reduction in catastrophic worry about pain and 63% a clinically significant increase in pain self-efficacy. Both overall and in their physical abilities, 88% of participants rated improvement from prior to the intervention.\nThere was no clinically significant deterioration on any measure for any of the participants.\n\nConclusions\nThe results of this pilot study suggest that a group PMP for women with CPP can be effective in reducing pain related disability for women with CPP.\n\n\nKeywords: Pelvic pain, pain management, chronic pain, endometriosis, group programme.