Effectiveness and cost-effectiveness of a group-based pain self-management intervention for patients undergoing total hip replacement: feasibility study for a randomized controlled trial
Open accessAbstract
BACKGROUND: Total hip replacement (THR) is a common elective surgical procedure and can be effective for reducing chronic pain. However, waiting times can be considerable. A pain self-management intervention may provide patients with skills to more effectively manage their pain and its impact during their wait for surgery. This study aimed to evaluate the feasibility of conducting a randomized controlled trial to assess the effectiveness and cost-effectiveness of a group-based pain self-management course for patients undergoing THR. METHODS: Patients listed for a THR at one orthopedic center were posted a study invitation pack. Participants were randomized to attend a pain self-management course plus standard care or standard care only. The lay-led course was delivered by Arthritis Care and consisted of two half-day sessions prior to surgery and one full-day session after surgery. Participants provided outcome and resource-use data using a diary and postal questionnaires prior to surgery and one month, three months and six months after surgery. Brief telephone interviews were conducted with non-participants to explore barriers to participation. RESULTS: Invitations were sent to 385 eligible patients and 88 patients (23%) consented to participate. Interviews with 57 non-participants revealed the most common reasons for non-participation were views about the course and transport difficulties. Of the 43 patients randomized to the intervention group, 28 attended the pre-operative pain self-management sessions and 11 attended the post-operative sessions. Participant satisfaction with the course was high, and feedback highlighted that patients enjoyed the group format. Retention of participants was acceptable (83% of recruited patients completed follow-up) and questionnaire return rates were high (72% to 93%), with the exception of the pre-operative resource-use diary (35% return rate). Resource-use completion rates allowed for an economic evaluation from the health and social care payer perspective. CONCLUSIONS: This study highlights the importance of feasibility work prior to a randomized controlled trial to assess recruitment methods and rates, barriers to participation, logistics of scheduling group-based interventions, acceptability of the intervention and piloting resource use questionnaires to improve data available for economic evaluations. This information is of value to researchers and funders in the design and commissioning of future research. TRIAL REGISTRATION: Current Controlled Trials ISRCTN52305381.
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The type of participants willing to engage in group format psychological interventions may have produced a self-selected sample that biased outcomes.
“The type of participants that are willing to engage in group format psychological interventions, as opposed to individual therapy or medication, may have produced a self-selected sample that biased outcomes (Wylde, Marques, Artz, Blom, & Gooberman-Hill, 2014).”
From Brief group‐based acceptance and commitment therapy for stroke survivors. (2019) · cites this paper as Wylde et al., 2014
The Discussion’s “Acceptability of the intervention” section (page not provided) says that some patients declined because of the group format and that participants’ preference for the intervention could produce a biased, self-selected sample. The study concerns a group-based pain self-management course for hip-replacement patients; it does not compare willingness to attend it with preferences for individual therapy or medication, or establish that outcomes were biased. (LLM, conf=0.87)
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- Authors
- Wylde, V., Marques, E., Artz, N., Blom, A., & Gooberman-Hill, R.
- Affiliations
- Southmead Hospital (GB)
- University of Bristol (GB)
- Corresponding author
- Wylde, Vikki
- Venue
- Trials
- Published
- 2014-05-20
- Volume
- 15
- Issue
- 1
- Pages
- 176-176
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC4031159
- OpenAlex
- W2102852469
- Cited by
- 12
- References
- 47
- Citations by year
- 2023: 1 · 2022: 1 · 2021: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 3 · 2014: 1
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Trials (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Repository (University of Gloucestershire) (acceptedVersion)
- UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (RP-PG-0407-10070)
- Programme Grants for Applied Research
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- total hip arthroplasty, pain self-management, group intervention, feasibility, cost-effectiveness, preoperative waiting time, resource utilization (health care), barriers to participation, participant retention, orthopedic surgery, patient education
- MeSH terms
- Clinical Protocols, Cost-Benefit Analysis, England, Feasibility Studies, Group Processes, Humans, Pain Measurement, Surveys and Questionnaires, Research Design, Self Care, Time Factors, Waiting Lists, Osteoarthritis, Hip, Treatment Outcome, Health Care Costs, Arthralgia, Arthroplasty, Replacement, Hip, Pain Management
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