Testing a newly developed activity pacing framework for chronic pain/fatigue : a feasibility study

Antcliff, D; Keenan, A-M; Keeley, P; Woby, SR; McGowan, L

Abstract

Objectives: To test the feasibility of using a new activity pacing framework to standardise healthcare professionals’ instructions of pacing, and explore whether measures of activity pacing/symptoms detected changes following treatment. Design: Single-arm, repeated measures study. Setting: One National Health Service (NHS) Pain Service in Northern England, UK. Participants: Adult patients with chronic pain/fatigue, including chronic low back pain, chronic widespread pain, fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis. Interventions: Six-week rehabilitation programme, standardised using the activity pacing framework. Outcome measures: Feasibility was explored via patients’ recruitment/attrition rates, adherence and satisfaction, and healthcare professionals’ fidelity. Questionnaire data were collected from patients at the start and end of the programme (T1 and T2, respectively) and 3 months’ follow-up (T3). Questionnaires included measures of activity pacing, current/usual pain, physical/mental fatigue, depression, anxiety, self-efficacy, avoidance, physical/mental function and quality of life. Mean changes in activity pacing and symptoms between T1-T2, T2-T3 and T1-T3 were estimated. Results: Of the 139 eligible patients, 107 patients consented (recruitment rate=77%); 65 patients completed T2 (T1-T2 attrition rate=39%), and 52 patients completed T3 (T1-T3 attrition rate=51%). At T2, patients’ satisfaction ratings averaged 9/10, and 89% attended ≥5 rehabilitation programme sessions. Activity pacing and all symptoms improved between T1 and T2, with smaller improvements maintained at T3. Conclusion: The activity pacing framework was feasible to implement and patients’ ability to pace and manage their symptoms improved. Future work will employ a suitable comparison group and test the framework across wider settings to explore the effects of activity pacing in a randomised controlled trial. Trial registration number: NCT03497585.

Citation

Antcliff, D., Keenan, A., Keeley, P., Woby, S., & McGowan, L. (2021). Testing a newly developed activity pacing framework for chronic pain/fatigue : a feasibility study. BMJ Open, 11(12), e045398. https://doi.org/10.1136/bmjopen-2020-045398

• Journal Article Type: Article
• Acceptance Date: Oct 25, 2021
• Online Publication Date: Dec 8, 2021
• Publication Date: Dec 8, 2021
• Deposit Date: Dec 13, 2021
• Publicly Available Date: Dec 13, 2021
• Journal: BMJ Open
• Publisher: BMJ Publishing Group
• Volume: 11
• Issue: 12
• Pages: e045398
• DOI: https://doi.org/10.1136/bmjopen-2020-045398
• Publisher URL: https://doi.org/10.1136/bmjopen-2020-045398
• Related Public URLs: http://bmjopen.bmj.com/
• Additional Information: Additional Information : ** Embargo end date: 08-12-2021 ** From BMJ via Jisc Publications Router ** Licence for this article starting on 08-12-2021: http://creativecommons.org/licenses/by-nc/4.0/ **Journal IDs: eissn 2044-6055 **Article IDs: publisher-id: bmjopen-2020-045398 **History: published_online 08-12-2021; published 12-2021; accepted 25-10-2021; submitted 29-09-2020