Authors (including presenting author) :
Law KL(1), Chan PC(1), Wong MC(1), Lee MY(2), Wong YH(3), Lim HS(4) Lau YH (5), Wong CM(5) Lee YKW(6), Wong SH(6), Wong HY (7) Chu WY (8) Chan SF(8)
Affiliation :
(1) KEC Pain Management Centre, (2) Day Surgery Centre, (3) Operating Room, (4)Anaesthesiology and Pain Medicine, United Christian Hospital (5) KEC Clinical Psychology Department (6)Physiotherapy Department (7)Occupational Therapy Department (8)Health Resource Centre
Introduction :
The recent COVID-19 pandemic has disrupted treatments and follow up for chronic pain patients. STEPS program, was a full day multidisciplinary pain management program in Kowloon East Cluster Pain Management Centre (KECPMC), had been cancelled or postponed. As a result, chronic pain patients may intensify their physical deconditioning, psychological distress and social isolation. It is suggested that online multidisciplinary pain management program offers an accessible, efficacious alternative and viable treatment option for chronic pain management (Smith, Gardner & Hobbs et.al., 2019). Coping with this challenge, KEC was a pioneered cluster to provide telecare service in maintaining quality patient care. KECPMC launched individual telehealth service since 5/2020. A pilot trial of hybrid face-to-face and telehealth based multidisciplinary pain management program is proposed to continue service.
Objectives :
To explore the feasibility and effectiveness of hybrid multidisciplinary telehealth based pain management program
Methodology :
A 14-days, 84 hours telehealth-based pain management program was implemented in April-May 2021.The day program consists of 2-hours face-to-face exercise program and 4-hours telehealth video-conference lecture sections based on cognitive behavioral therapy for chronic pain patient. Six chronic musculoskeletal pain patients were recruited in the program who aged 36-66 years old. They are able to assess network and use ‘zoom app’ for lecture. Trial section of using zoom was performed 1 week before the program. Pain intensity, pain catastrophizing thoughts, pain related self-efficacy and depression, stress and anxiety level were reported before and after the program. Physical tolerance and endurance were measured for physical fitness condition.
Result & Outcome :
Six patients completed the program, the attendance rate was 98%, with the mean 80 hours, showing good treatment compliance. There were 30% reduction of mean self-reported lowest pain score and 13%-245% improvement in static sitting, standing and walking tolerance, 12min walk, 20 metre walking, loaded walking and upper limb endurance mean time. Stress and depression level were reduced from severe to moderate. Pain self-efficacy scale which represents patient efficacy to perform productive activities despite the pain was improved. However, there was no improvement in anxiety level, pain catastrophizing thoughts after the program.Health care staffs maintained safe access to multidisciplinary care for chronic pain patients. Telehealth based pain management program is feasible and able to provide positive outcome. Review on the format and content of telehealth lecture are needed to address patients’ anxiety and pain catastrophizing thoughts. The entire contents of the telehealth based CBT program may be revamped to enhance its equivalence to face-to-face conducted format.
