Improving the self-management of chronic pain: COping with persistent Pain, Effectiveness Research in Self-management (COPERS)

Taylor, Stephanie JC; Carnes, Dawn; Homer, Kate; Pincus, Tamar; Kahan, Brennan C; Hounsome, Natalia; Eldridge, Sandra; Spencer, Anne; Diaz-Ordaz, Karla; Rahman, Anisur; Mars, Tom S; Foell, Jens; Griffiths, Chris J; Underwood, Martin R

doi:10.3310/pgfar04140

Cited by 44Musculoskeletal pain and rehabilitationPediatric Pain Management TechniquesHealth Policy Implementation Science

Improving the self-management of chronic pain: COping with persistent Pain, Effectiveness Research in Self-management (COPERS)

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Taylor, Stephanie JC, Carnes, Dawn, Homer, Kate, Pincus, Tamar, Kahan, Brennan C, Hounsome, Natalia, Eldridge, Sandra, Spencer, Anne +6 more·2016·Programme Grants for Applied Research

DOI 10.3310/pgfar04140

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Abstract

Background: Chronic musculoskeletal pain is a common problem that is difficult to treat. Self-management support interventions may help people to manage this condition better; however, there is limited evidence showing that they improve clinical outcomes. Our overarching research question was ‘Does a self-management support programme improve outcomes for people living with chronic musculoskeletal pain?’. Aim: To develop, evaluate and test the clinical effectiveness and cost-effectiveness of a theoretically grounded self-management support intervention for people living with chronic musculoskeletal pain. Methods: In phase 1 we carried out two systematic reviews to synthesise the evidence base for self-management course content and delivery styles likely to help those with chronic pain. We also considered the psychological theories that might underpin behaviour change and pain management principles. Informed by these data we developed the Coping with persistent Pain, Evaluation Research in Self-management (COPERS) intervention, a group intervention delivered over 3 days with a top-up session after 2 weeks. It was led by two trained facilitators: a health-care professional and a layperson with experience of chronic pain. To ensure that we measured the most appropriate outcomes we reviewed the literature on potential outcome domains and measures and consulted widely with patients, tutors and experts. In a feasibility study we demonstrated that we could deliver the COPERS intervention in English and, to increase the generalisability of our findings, also in Sylheti for the Bangladeshi community. In phase 2 we ran a randomised controlled trial to test the clinical effectiveness and cost-effectiveness of adding the COPERS intervention to a best usual care package (usual care plus a relaxation CD and a pain toolkit leaflet). We recruited adults with chronic musculoskeletal pain largely from primary care and musculoskeletal physiotherapy services in two localities: east London and Coventry/Warwickshire. We collected follow-up data at 12 weeks (self-efficacy only) and 6 and 12 months. Our primary outcome was pain-related disability (Chronic Pain Grade disability subscale) at 12 months. We also measured costs, health utility (European Quality of Life-5 Dimensions), anxiety, depression [Hospital Anxiety and Depression Scale (HADS)], coping, pain acceptance and social integration. Data on the use of NHS services by participants were extracted from NHS electronic records. Results: We recruited 703 participants with a mean age of 60 years (range 19–94 years); 81% were white and 67% were female. Depression and anxiety symptoms were common, with mean HADS depression and anxiety scores of 7.4 [standard deviation (SD) 4.1] and 9.2 (SD 4.6), respectively. Intervention participants received 85% of the course content. At 12 months there was no difference between treatment groups in our primary outcome of pain-related disability [difference –1.0 intervention vs. control, 95% confidence interval (CI) –4.9 to 3.0]. However, self-efficacy, anxiety, depression, pain acceptance and social integration all improved more in the intervention group at 6 months. At 1 year these differences remained for depression (–0.7, 95% CI –1.2 to –0.2) and social integration (0.8, 95% CI, 0.4 to 1.2). The COPERS intervention had a high probability (87%) of being cost-effective compared with usual care at a threshold of £30,000 per quality-adjusted life-year. Conclusions: Although the COPERS intervention did not affect our primary outcome of pain-related disability, it improved psychological well-being and is likely to be cost-effective according to current National Institute for Health and Care Excellence criteria. The COPERS intervention could be used as a substitute for less well-evidenced (and more expensive) pain self-management programmes. Effective interventions to improve hard outcomes in chronic pain patients, such as disability, are still needed. Trial registration: Current Controlled Trials ISRCTN22714229. Funding: The project was funded by the National Institute for Health Research Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research ; Vol. 4, No. 14. See the NIHR Journals Library website for further project information.

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The authors' previous experience is that the challenges of running non-English language group interventions for chronic painful disorders are too great to do successfully within an RCT.
“Our previous experience is that the challenges of running non-English language group interventions for chronic painful disorders are too great to do successfully within an RCT.22”
From Usual care and a self-management support programme versus usual care and a relaxation programme for people living with chronic headache disorders: A randomised controlled trial protocol (CHESS) (2020) · cites this paper as [22]
The Introduction (page not available) reports that the pilot ran three Sylheti-language courses in a non-randomised arm and recommended conducting the main trial in English only. That supports a decision not to include non-English courses in this RCT, but it does not establish the broader claim that the challenges of running such interventions are too great for any RCT to succeed. (LLM, conf=0.82)
Experimental — accuracy not yet measured
HADs has been used in many previous studies of chronic pain, including the COPERS study where positive effects on both anxiety and depression were identified in a chronic pain population.
“HADs has been used in many previous studies of chronic pain, including the COPERS (Coping with persistent Pain, Effectiveness Research into Self-management) study where we identified positive effects on both anxiety and depression in a chronic pain population.22 34”
From Usual care and a self-management support programme versus usual care and a relaxation programme for people living with chronic headache disorders: A randomised controlled trial protocol (CHESS) (2020) · cites this paper as [22]

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“Response Baseline, n (%) 6 months, n (%) 12 months, n (%) Control Intervention Control Intervention Control Intervention Very good 17 (6) 27 (7) 11 (5) 20 (6) 8 (3) 14 (4) Good 100 (33) 138 (34) 81 (34) 121 (35) 84 (34) 130 (38) Fair 130 (43) 159 (39) 100 (42) 144 (42) 115 (47) 144 (42) Bad 45 (15) 63 (16) 39 (16) 46…”
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“5) 0, 0 Male 98 (33) 132 (33) 0, 0 Lives alone 101 (34) 143 (36) 4, 6 Ethnicity White 239 (80) 325 (81) 0, 0 Black 36 (12) 53 (13) Asian 20 (7) 13 (3) Mixed 5 (2) 9 (2) Other 0 (0) 3 (1) Self-rated English language fluency Fluent 259 (86) 341 (85) 0, 0 Good 36 (12) 56 (14) Below average 3 (1) 6 (1) Poor 2 (1) 0 (0) Ag…”
BackgroundInfluential
Critical dimensions in the choice and maintenance of successful treatments: Strength, integrity, and effectiveness.
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“Characteristic Sylheti speaking (N= 26), n (%) English speaking (N= 48), n (%) Employment Employed 1 (4) 13 (27) Family/home keeper 8 (31) 5 (10) Retired 1 (4) 8 (17) Unable to work because of ill health 4 (15) 17 (35) Unemployed 3 (12) 5 (10) Missing 9 (35) 0 (0) Education None 3 (12) 1 (2) Until < 12 years 4 (15) 0…”
BackgroundInfluential
Modes of social support: The social support behaviors (SS‐B) scale
Vaux, A., Riedel, S. L., & Stewart, D. (1987) · American Journal of Community Psychology · doi:10.1007/bf00919279 · Cited by 346 · see citing works
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Early management of persistent non-specific low back pain: summary of NICE guidance
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“Response Baseline, n (%) 6 months, n (%) 12 months, n (%) Control Intervention Control Intervention Control Intervention Very good 17 (6) 27 (7) 11 (5) 20 (6) 8 (3) 14 (4) Good 100 (33) 138 (34) 81 (34) 121 (35) 84 (34) 130 (38) Fair 130 (43) 159 (39) 100 (42) 144 (42) 115 (47) 144 (42) Bad 45 (15) 63 (16) 39 (16) 46…”
BackgroundSelf-citation
What Is Acceptance and Commitment Therapy?
Hayes, S. C., Strosahl, K. D., Bunting, K., Twohig, M., & Wilson, K. G. (2004) · A Practical Guide to Acceptance and Commitment Therapy · doi:10.1007/978-0-387-23369-7_1 · Cited by 301 · see citing works
Individual patient education for low back pain
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“Characteristics Control (N= 300), n (%) Intervention (N= 403), n (%) Number of participants with missing data (control, intervention) State of health Very good 17 (6) 27 (7) 0, 0 Good 100 (33) 138 (34) Fair 130 (43) 159 (39) Bad 45 (15) 63 (16) Very bad 8 (3) 16 (4) Duration of pain 0–3 months 4 (1) 1 (< 1) 0, 0 4–12…”
Background
Tailored cognitive-behavioral therapy in early rheumatoid arthritis for patients at risk: a randomized controlled trial
Evers, A. W. M., Kraaimaat, F. W., van Riel, P. L. C. M., & de Jong, A. J. L. (2002) · Pain · doi:10.1016/s0304-3959(02)00274-9 · Cited by 301 · see citing works
Cognitive–behavioral treatment of insomnia secondary to chronic pain.
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“Exposure London, n (%) Warwick, n (%) Both, n (%) Adherent (≥ 17 sessions) 115 (63) 167 (76) 282 (70) Moderate adherence (9–16 sessions) 16 (9) 10 (5) 26 (6) Non-adherent (≤ 8 sessions) 52 (28) 43 (20) 95 (24) Total 183 (100) 220 (100) 403 (100) Complier (≥ 12 sessions) 130 (71) 175 (80) 305 (76) Non-complier (≤ 11 se…”
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Cognitive-behavioral treatment of insomnia secondary to chronic pain.
Currie, S. R., Wilson, K. G., Pontefract, A. J., & deLaplante, L. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.68.3.407 · Cited by 299 · see citing works
Reporting and analysis of trials using stratified randomisation in leading medical journals: review and reanalysis
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The cultural diversity of healing: meaning, metaphor and mechanism
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Catastrophizing and internal pain control as mediators of outcome in the multidisciplinary treatment of chronic low back pain
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Comparison of cognitive-behavioral group treatment and an alternative non-psychological treatment for chronic low back pain
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British National Formulary
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“W20 Community centre Physiotherapist and lay person 9 6 (67) 69”
Background
A randomized clinical trial using research diagnostic criteria for temporomandibular disorders-axis II to target clinic cases for a tailored self-care TMD treatment program.
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Life stress, social support, and psychological vulnerability: Epidemiological considerations
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A randomized trial of a lay person-led self-management group intervention for back pain patients in primary care.
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“Participants Number contacted Total number booked on a course (% of those contacted) Attendance at day 1 (% of those approached/booked) English-speaking females 228 30 (13) 23 (77) English-speaking males 134 26 (19) 19 (73) Sylheti-speaking females 115 34 (30) 22 (65) Sylheti-speaking males 46 7 (15) 4 (57) FEASIBILIT…”
Background
Self-management education programmes for osteoarthritis
Kroon, F. P. B., van der Burg, L. R. A., Buchbinder, R., Osborne, R. H., Johnston, R. V., & Pitt, V. J. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008963.pub2 · Cited by 252 · cited 8× · see citing works
“5) 0, 0 Male 98 (33) 132 (33) 0, 0 Lives alone 101 (34) 143 (36) 4, 6 Ethnicity White 239 (80) 325 (81) 0, 0 Black 36 (12) 53 (13) Asian 20 (7) 13 (3) Mixed 5 (2) 9 (2) Other 0 (0) 3 (1) Self-rated English language fluency Fluent 259 (86) 341 (85) 0, 0 Good 36 (12) 56 (14) Below average 3 (1) 6 (1) Poor 2 (1) 0 (0) Ag…”
BackgroundInfluential
A randomized trial of a cognitive-behavioral program for enhancing back pain self care in a primary care setting.
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Delivering the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cost effectiveness analysis
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Chronic musculoskeletal pain rarely presents in a single body site: results from a UK population study
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Systematic reviews of low back pain prognosis had variable methods and results—guidance for future prognosis reviews
Hayden, J. A., Chou, R., Hogg‐Johnson, S., & Bombardier, C. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2008.09.004 · Cited by 243 · cited 4× · see citing works
“Response Baseline, n (%) 6 months, n (%) 12 months, n (%) Control Intervention Control Intervention Control Intervention Very good 17 (6) 27 (7) 11 (5) 20 (6) 8 (3) 14 (4) Good 100 (33) 138 (34) 81 (34) 121 (35) 84 (34) 130 (38) Fair 130 (43) 159 (39) 100 (42) 144 (42) 115 (47) 144 (42) Bad 45 (15) 63 (16) 39 (16) 46…”
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A Social–Ecologic Approach to Assessing Support for Disease Self-Management: The Chronic Illness Resources Survey
Glasgow, R. E., Strycker, L. A., Toobert, D. J., & Eakin, E. (2000) · Journal of Behavioral Medicine · doi:10.1023/a:1005507603901 · Cited by 242 · see citing works
Therapist Alliance-Building Behavior Within a Cognitive-Behavioral Treatment for Anxiety in Youth.
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A social support measure: PRQ85.
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Predicting satisfaction with social support from social network structure
Stokes, J. P. (1983) · American Journal of Community Psychology · doi:10.1007/bf00894363 · Cited by 239 · see citing works
Implementation of self management support for long term conditions in routine primary care settings: cluster randomised controlled trial
Kennedy, A., Bower, P., Reeves, D., Blakeman, T., Bowen, R., Chew-Graham, C., Eden, M., Fullwood, C., Gaffney, H., Gardner, C., et al. (2013) · BMJ · doi:10.1136/bmj.f2882 · Cited by 239 · see citing works
How effective are expert patient (lay led) education programmes for chronic disease?
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Self-citation
Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain
Little, P. S., Lewith, G. T., Webley, F., Evans, M. A., Beattie, A., Middleton, K., Barnett, J., Ballard, K., Oxford, F., Smith, P. W. F., et al. (2008) · BMJ · doi:10.1136/bmj.a884 · Cited by 235 · see citing works
Untitled work
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Controlled trial of Internet-based treatment with telephone support for chronic back pain
Buhrman, M., Fältenhag, S., Ström, L., & Andersson, G. (2004) · Pain · doi:10.1016/j.pain.2004.07.021 · Cited by 232 · cited 1× · see citing works
“Service Baseline, n (%) 6-month follow-up, n (%) 12-month follow-up, n (%) Intervention Control Intervention Control Intervention Control Consultations NA NA 370 (92) 276 (92) 370 (92) 276 (92) Prescriptions 332 (82) 229 (76) 350 (87) 258 (86) 350 (87) 258 (86) Investigations NA NA 370 (92) 276 (92) 370 (92) 276 (92)…”
Coping with chronic pain: a comparison of two measures
Tan, G., Jensen, M. P., Robinson-Whelen, S., Thornby, J. I., & Monga, T. N. (2001) · Pain · doi:10.1016/s0304-3959(00)00395-x · Cited by 230 · see citing works
Active rehabilitation for chronic low back pain: Cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]
Smeets, R., Vlaeyen, J. W. S., Hidding, A., Kester, A. D. M., van der Heijden, G. J. M. G., van Geel, A. C., & Knottnerus, J. A. (2006) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-7-5 · Cited by 226 · see citing works
Impact of the Fit and Strong Intervention on Older Adults With Osteoarthritis
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Development of a Fidelity Measure for Research on the Effectiveness of the Ayres Sensory Integration ® Intervention
Parham, L. D., Roley, S. S., May-Benson, T. A., Koomar, J. A., Brett‐Green, B., Burke, J. P., Cohn, E. S., Mailloux, Z., Miller, L. J., & Schaaf, R. C. (2011) · American Journal of Occupational Therapy · doi:10.5014/ajot.2011.000745 · Cited by 222 · cited 1× · see citing works
“Parameter Complete data set Imputed data set Intervention, mean (SD) Control, mean (SD) Intervention, mean (SD) Control, mean (SD) Baseline prescription cost (£) 154 (252) 176 (253) 148 (273) 161 (257) Baseline EQ-5D score 0.”
Background
Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS‐SSS‐C)
Yu, D. S. F., Lee, D., & Woo, J. (2004) · Research in Nursing & Health · doi:10.1002/nur.20008 · Cited by 218 · see citing works
Self-Efficacy for Managing Pain Is Associated With Disability, Depression, and Pain Coping Among Retirement Community Residents With Chronic Pain
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Fibromyalgia: a randomised, controlled trial of a treatment programme based on self management
Cedraschi, C., Desmeules, J., Rapiti, E., Baumgartner, E., Cohen, P., Finckh, A., Allaz, A. F., & Vischer, T. L. (2004) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2002.004945 · Cited by 216 · cited 1× · see citing works
“W07 Community centre Physiotherapist and lay person 10 9 (90) 93”
Background
Self management of arthritis in primary care: randomised controlled trial
Buszewicz, M., Rait, G., Griffin, M., Nazareth, I., Patel, A. K., Atkinson, A., Barlow, J. H., & Haines, A. (2006) · BMJ · doi:10.1136/bmj.38965.375718.80 · Cited by 214 · cited 2× · see citing works
“0) Male 215 (33) 15 (29) Living alone 218 (33) 26 (51) Ethnicity White 523 (80) 41 (80) Black 83 (13) 6 (12) Asian 30 (5) 3 (6) Mixed or other 16 (2) 1 (2) Fluent in or good at English 642 (98) 50 (98) Age at which formal education ended ≤ 12 years 6 (1) 0 (0) 13–19 years 472 (72) 37 (73) ≥ 20 years or still in full-t…”
Cognitive and affective reassurance and patient outcomes in primary care: A systematic review
Pincus, T., Holt, N., Vogel, S., Underwood, M., Savage, R., Walsh, D., & Taylor, S. (2013) · Pain · doi:10.1016/j.pain.2013.07.019 · Cited by 214 · cited 6× · see citing works
“Characteristic Sylheti speaking (N= 26), n (%) English speaking (N= 48), n (%) Employment Employed 1 (4) 13 (27) Family/home keeper 8 (31) 5 (10) Retired 1 (4) 8 (17) Unable to work because of ill health 4 (15) 17 (35) Unemployed 3 (12) 5 (10) Missing 9 (35) 0 (0) Education None 3 (12) 1 (2) Until < 12 years 4 (15) 0…”
BackgroundInfluentialSelf-citation
Social support and health-related quality of life in chronic heart failure patients
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The NHS outcomes framework 2012-3
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A Social Support Measure
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“Characteristic Sylheti speaking (N= 26), n (%) English speaking (N= 48), n (%) Employment Employed 1 (4) 13 (27) Family/home keeper 8 (31) 5 (10) Retired 1 (4) 8 (17) Unable to work because of ill health 4 (15) 17 (35) Unemployed 3 (12) 5 (10) Missing 9 (35) 0 (0) Education None 3 (12) 1 (2) Until < 12 years 4 (15) 0…”
Research in Community and Mental Health
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Behavioural treatment for chronic low-back pain
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“Unemployed and looking for work 10 (3) 20 (5) Still in full-time education 3 (1) 1 (< 1) Unable to work because of long-term sickness 62 (21) 86 (21) Looking after home/family 14 (5) 23 (6) Retired from paid work 132 (44) 175 (43) Other 1 (< 1) 7 (2) Time kept from usual activities because of pain in the past 6 months…”
BackgroundInfluential
Untitled work
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Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity
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“5) 0, 0 Male 98 (33) 132 (33) 0, 0 Lives alone 101 (34) 143 (36) 4, 6 Ethnicity White 239 (80) 325 (81) 0, 0 Black 36 (12) 53 (13) Asian 20 (7) 13 (3) Mixed 5 (2) 9 (2) Other 0 (0) 3 (1) Self-rated English language fluency Fluent 259 (86) 341 (85) 0, 0 Good 36 (12) 56 (14) Below average 3 (1) 6 (1) Poor 2 (1) 0 (0) Ag…”
BackgroundInfluential
The measurement of social support in population surveys
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Systematic Review of Relaxation Interventions for Pain
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The Effectiveness of Multidisciplinary Rehabilitation in the Treatment of Fibromyalgia: A Randomized Controlled Trial
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A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender?
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An Online Self-help CBT Intervention for Chronic Lower Back Pain
Carpenter, K. M., Stoner, S. A., Mundt, J. M., & Stoelb, B. (2012) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e31822363db · Cited by 157 · see citing works
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Accounting for centre-effects in multicentre trials with a binary outcome – when, why, and how?
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The effects of an exercise program for older adults with osteoarthritis of the hip.
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The combat exposure scale: A systematic assessment of trauma in the vietnam war
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Effects of dietary intervention and quadriceps strengthening exercises on pain and function in overweight people with knee pain: randomised controlled trial
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“0) Male 215 (33) 15 (29) Living alone 218 (33) 26 (51) Ethnicity White 523 (80) 41 (80) Black 83 (13) 6 (12) Asian 30 (5) 3 (6) Mixed or other 16 (2) 1 (2) Fluent in or good at English 642 (98) 50 (98) Age at which formal education ended ≤ 12 years 6 (1) 0 (0) 13–19 years 472 (72) 37 (73) ≥ 20 years or still in full-t…”
A comparison of lay-taught and professional-taught arthritis self-management courses.
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1st Annual Crossing the Quality Chasm Summit: A Focus on Communities
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The measurement of social support in the ‘European research on incapacitating diseases and social support’: The development of the Social Support Questionnaire for Transactions (SSQT)
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Measuring psychiatric disorder among Southeast Asian refugees
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A Dictionary of Statistics
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Flagged first, then by citations

2 of the 352 references couldn’t be matched to a known paper.

Sorted by citations

Digital Support Interventions for the Self-Management of Low Back Pain: A Systematic Review
Nicholl, B. I., Sandal, L. F., Stochkendahl, M. J., McCallum, M., Suresh, N., Vasseljen, O., Hartvigsen, J., Mork, P. J., Kjær, P., Søgaard, K., et al. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7290 · Cited by 180 · see citing works
“In addition, these reviews have suggested that future studies should extend the outcomes of interest to include aspects of self-efficacy, and also consider the impact of the duration of the intervention [13,40], increase the length of follow-up [16], and also consider the impact of such interventions on health care ut…”
Background
The effectiveness of generic self‐management interventions for patients with chronic musculoskeletal pain on physical function, self‐efficacy, pain intensity and physical activity: A systematic review and meta‐analysis
Elbers, S., Wittink, H. M., Pool, J. J. M., & Smeets, R. (2018) · European Journal of Pain · doi:10.1002/ejp.1253 · Cited by 92 · see citing works
Opioid prescribing for chronic musculoskeletal pain in UK primary care: results from a cohort analysis of the COPERS trial
Ashaye, T., Hounsome, N., Carnes, D., Taylor, S. J., Homer, K., Eldridge, S. M., Spencer, A. E., Rahman, A., Foell, J., & Underwood, M. R. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-019491 · Cited by 77 · see citing works
“The demography of the study participants was: 67% female, mean age 60 years (52 years in London and 67 in Midlands) and 81% white British.”
InfluentialSelf-citation
GLA:D® Back: implementation of group-based patient education integrated with exercises to support self-management of back pain - protocol for a hybrid effectiveness-implementation study
Kongsted, A., Ris, I., Kjær, P., Vach, W., Morsø, L., & Hartvigsen, J. (2019) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-019-2443-1 · Cited by 57 · see citing works
Development of an education and self-management intervention for chronic headache – CHESS trial (Chronic Headache Education and Self-management Study)
On behalf of the CHESS team, Patel, S., Potter, R. C., Matharu, M. S., Carnes, D., Taylor, S. J., Nichols, V. P., Pincus, T., Underwood, M. R., & Sandhu, H. K. (2019) · The Journal of Headache and Pain · doi:10.1186/s10194-019-0980-5 · Cited by 36 · see citing works
“With the associated links between chronic headaches and those with chronic pain, we have drawn upon the knowledge and experience of intervention design and delivery from those involved in the design and running of the COPERS study [37].”
BackgroundInfluentialSelf-citation
Pain management programmes via video conferencing: a rapid review
Walumbe, J., Belton, J., & Denneny, D. (2021) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2020-0112 · Cited by 29 · see citing works
Usual care and a self-management support programme versus usual care and a relaxation programme for people living with chronic headache disorders: A randomised controlled trial protocol (CHESS)
Patel, S., Achana, F., Carnes, D., Eldridge, S., Ellard, D. R., Griffiths, F., Haywood, K., Hee, S. W., Mistry, D., Mistry, H., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033520 · Cited by 24 · see citing works
Self-citation
The Management of Chronic Back Pain in Primary Care Settings: Exploring Perceived Facilitators and Barriers to the Development of Patient–Professional Partnerships
Fu, Y., McNichol, E., Marczewski, K., & Closs, S. J. (2018) · Qualitative Health Research · doi:10.1177/1049732318768229 · Cited by 24 · see citing works
“, 2013; Henshall, Greenfield, & Gale, 2017) and cost-effective (Taylor et al., 2016).”
Background
Adherence to and the Maintenance of Self-Management Behaviour in Older People with Musculoskeletal Pain—A Scoping Review and Theoretical Models
Söderlund, A., & Wågert, P. V. H. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10020303 · Cited by 24 · see citing works
Work-anxiety-coping intervention improves work-coping perception while a recreational intervention leads to deterioration: Results from a randomized controlled trial
Muschalla, B. (2017) · European Journal of Work and Organizational Psychology · doi:10.1080/1359432x.2017.1384378 · Cited by 19 · see citing works
“Coping covers different forms of cognitive and acting behaviours, which can be modified (e.g., Clark & Beck, 2009; Lazarus, 1993; Nieuwenhuijsen et al., 2014; Taylor et al., 2016).”
Background
Development and delivery of the BOOST (Better Outcomes for Older adults with Spinal Trouble) intervention for older adults with neurogenic claudication
Ward, L., Williamson, E. M., Hansen, Z., French, D., Boniface, G., Rogers, D., & Lamb, S. E. (2019) · Physiotherapy · doi:10.1016/j.physio.2019.01.019 · Cited by 17 · see citing works
“A conceptual model of the change processes, active intervention elements, and potential moderators [16] of the BOOST intervention is presented in Fig.”
Background
Developing a new approach to persistent pain management in osteopathic practice. Stage 1: a feasibility study for a group course
Nanke, L., & Abbey, H. (2017) · International journal of osteopathic medicine · doi:10.1016/j.ijosm.2017.10.001 · Cited by 16 · see citing works
Nurses back pain beliefs, coping strategies and factors associated with participant activation for self‐management of back pain
Nkhata, L. A., Brink, Y., Ernstzen, D. V., & Louw, Q. A. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14890 · Cited by 16 · see citing works
Chronic Pain Self-Management Program for Low-Income Patients: Themes from a Qualitative Inquiry
Turner, B. J., Rodriguez, N., Bobadilla, R., Hernández, A. E., & Yin, Z. (2018) · Pain Medicine · doi:10.1093/pm/pny192 · Cited by 12 · see citing works
Understanding peer mentorship in supporting self‐management of hip and knee osteoarthritis: A qualitative study of mentees' perspectives
Lavender, E. C., Anderson, A. M., Richards, E., Antcliff, D., Kingsbury, S. R., Conaghan, P. G., & McHugh, G. A. (2021) · Musculoskeletal Care · doi:10.1002/msc.1580 · Cited by 11 · see citing works
Exploring the feasibility, acceptability and value of volunteer peer mentors in supporting self-management of osteoarthritis: a qualitative evaluation
Lavender, E. C., Richards, E., Anderson, A. M., Antcliff, D., McGowan, L., Conaghan, P. G., Kingsbury, S. R., & McHugh, G. A. (2021) · Disability and Rehabilitation · doi:10.1080/09638288.2021.1964625 · Cited by 11 · see citing works
Development and feasibility of an intervention featuring individual supported work placements to aid return to work for unemployed people living with chronic pain
Froud, R., Grant, M., Burton, K. A., Foss, J. G. K., Ellard, D. R., Seers, K., Smith, D., Barillec, M., Patel, S., Haywood, K. L., et al. (2020) · Pilot and Feasibility Studies · doi:10.1186/s40814-020-00581-6 · Cited by 10 · see citing works
“6/1,000 patients in those settings, which would make recruitment from general practice to any subsequent main trial challenging [28].”
BackgroundSelf-citation
Body Reprogramming: Reframing the Fibromyalgia narrative and providing an integrative therapeutic model
Davies, A. F., Hill, P. J., Fay, D., Dee, A., & Locher, C. (2020) · Health Psychology Open · doi:10.1177/2055102920971494 · Cited by 10 · see citing works
“Those incorporating a psychological component show more consistent beneficial effects over the follow-up period (Taylor et al., 2016).”
Background
Non-pharmacological educational and self-management interventions for people with chronic headache: the CHESS research programme including a RCT
Underwood, M. R., Achana, F. A., Carnes, D., Eldridge, S. M., Ellard, D. R., Griffiths, F. E., Haywood, K. L., Hee, S. W., Higgins, H. B., Mistry, D., et al. (2023) · Programme Grants for Applied Research · doi:10.3310/pljl1440 · Cited by 10 · see citing works
Self-citation
Interventions for supporting self-management in people with musculoskeletal pain, including focus on varying levels of health literacy: A systematic overview of reviews
Babatunde, O. O., Shivji, N. A., Rowlands, G., Quicke, J. G., Healey, E. L., Protheroe, J., & van der Windt, D. (2023) · Health Open Research · doi:10.12688/healthopenres.13151.1 · Cited by 8 · see citing works
Massage Therapy as a Self-Management Strategy for Musculoskeletal Pain and Chronic Conditions: A Systematic Review of Feasibility and Scope
Nemati, D., Hinrichs, R., Johnson, A. J., Lauche, R., & Munk, N. (2023) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2023.0271 · Cited by 9 · see citing works
“7 11 Cost–beneﬁt and improved health outcomes attributed to self-management might have substantial advantages in the United States due to the health care system’s complexity and high costs of treatment for chronic conditions that exacerbate health disparities associated with limited access and…”
The effectiveness of peer support interventions for community-dwelling adults with chronic musculoskeletal pain: a systematic review and meta-analysis of randomised trials
Wilson, M. V., BRAITHWAITE, F., Arnold, J. B., Crouch, S. M., Moore, E., Heil, A. M., Cooper, K., & Stanton, T. R. (2024) · Pain · doi:10.1097/j.pain.0000000000003293 · Cited by 8 · see citing works
Robust Inference for Mediated Effects in Partially Linear Models
Hines, O., Vansteelandt, S., & Diaz‐Ordaz, K. (2021) · Psychometrika · doi:10.1007/s11336-021-09768-z · Cited by 8 · see citing works
“Illustrative Example: The COPERS Trial We now illustrate our G-estimation procedure and hypothesis testing methods, by analysing data from the COPERS (COping with persistent Pain, Effectiveness Research in Selfmanagement) trial (Taylor et al. 2016).”
BackgroundMethodSelf-citation
PRISM—Pain Recovery and Integrative Systems Model: A Process-Based Cognitive-Behavioral Approach for Physical Therapy
Tatta, J., Pignataro, R. M., Bezner, J. R., George, S. Z., & Rothschild, C. E. (2023) · Physical Therapy · doi:10.1093/ptj/pzad077 · Cited by 8 · see citing works
Nurses’ beliefs about back pain, their coping strategies and participant activation for self-management
Nkhata, L. A., Brink, Y., Ernstzen, D. V., Bedada, D. T., & Louw, Q. A. (2022) · South African Journal of Physiotherapy · doi:10.4102/sajp.v78i1.1622 · Cited by 6 · see citing works
“Education and behaviour modification are used to motivate people to actively participate in managing their health and lessening the condition’s negative effects on their physical functioning and well-being (Patel et al. 2019; Taylor et al. 2016).”
Background
A six-participant pilot single-subject study of an individualized pain management program for people with spinal cord injury
Proulx, K., Lamontagne, M., Quirion, R., Deaudelin, I., Mercier, C., & Perreault, K. (2023) · Spinal Cord Series and Cases · doi:10.1038/s41394-022-00557-z · Cited by 5 · see citing works
Factors affecting the effectiveness of ‘ruqyah’ treatment among Muslim community in Malaysia
Omar, M., Abdullah, M., Ahmad, A. R., Amin, A. R. M., Shafei, S. A., Haron, S., Ramli, R., Hussian, M. A., Kusmin, Z. A., Haron, H., et al. (2024) · Journal of Spirituality in Mental Health · doi:10.1080/19349637.2024.2338839 · Cited by 4 · see citing works
“…patients’ own management and responsibility for their condition, and many self-management programs have been developed in response to the increasing burden of chronic diseases and proven effective (Boyers et al., 2013; Henshall, Greenfield, & Gale, 2017) and cost-effective (Taylor et al., 2016).”
Sound of Care: Towards a Co-Operative AI Digital Pain Companion to Support People with Chronic Primary Pain
Sette, B. M. D., Carnes, D., & Saitis, C. (2023) · ACM Conference on Computer Supported Cooperative Work (CSCW) · doi:10.1145/3584931.3606971 · Cited by 4 · see citing works
“The use of distraction aligns with current strategies in Cognitive Behavioural Therapy for pain self-management [25], however for our interviewees technology plays a major, but mostly unstructured role in this process.”
MethodSelf-citation
Treated versus self-reported prevalence of chronic pain and costs of patients’ health services utilization: a population-based study of health administrative databases
Thành, N. X., Lopatina, E., Montgomery, L. S., Robert, M., Tanguay, R. L., & Wasylak, T. (2023) · British Journal of Pain · doi:10.1177/20494637231209928 · Cited by 4 · see citing works
“Among others, further studies would also look at interventions improving self-management of CP, given the probability of self-management of CP being effective 21,22 and cost-effective, 23 and the feasibility of digital self-management of CP interventions.”
Background
Efficacy of chronic neck pain self-treatment using press needles: a randomized controlled clinical trial
Horike, K., & Ukezono, M. M. (2024) · Frontiers in Pain Research · doi:10.3389/fpain.2024.1301665 · Cited by 3 · see citing works
The clinical effectiveness of a self-management intervention for patients with persistent depressive disorder and their partners/caregivers: results from a multicenter, pragmatic randomized controlled trial
Solis, E. C., Carlier, I. V. E., Kamminga, N. G. A., Giltay, E. J., & van Hemert, A. M. (2024) · Trials · doi:10.1186/s13063-024-08033-9 · Cited by 3 · see citing works
Development and content validity of the musculoskeletal self-management questionnaire (MSK-SMQ)
Hutting, N., Belton, J. L., Cañeiro, J. P., Oliveira, V. C., Devan, H., Johnston, V., Moore, P., Richardson, J. A., Staal, J. B., & Walsh, N. E. (2025) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2025.103342 · Cited by 6 · see citing works
Participants and developers experiences with a chronic pain self-management intervention under development: A qualitative study
Grønning, K., Nøst, T. H., Rannestad, T., & Bratås, O. (2018) · SAGE Open Medicine · doi:10.1177/2050312118817427 · Cited by 3 · see citing works
Mental Disorders in Chronic Pain Patients Seeking Treatment at a Tertiary Pain Hospital
Thomas, M. V., Ryckeghem, D. M. L. V., Schulz, A., Müller, R., Lambracht, K., Adermann, J., & Vögele, C. (2024) · European Journal of Health Psychology · doi:10.1027/2512-8442/a000142 · Cited by 4 · see citing works
Data-adaptive doubly robust instrumental variable methods for treatment effect heterogeneity
Diaz‐Ordaz, K., Daniel, R., & Kreif, N. (2018) · LSHTM Research Online (London School of Hygiene and Tropical Medicine) · doi:10.48550/arxiv.1802.02821 · Cited by 3 · see citing works
“The original report included a causal treatment effect analysis using TSLS, using a binary indicator for treatment received (attending at least half of the sessions), and assuming that randomisation was a valid instrument for treatment received (Taylor et al., 2016).”
MethodSelf-citation
Local average treatment effects estimation via substantive model compatible multiple imputation
Diaz‐Ordaz, K., & Carpenter, J. R. (2019) · Biometrical Journal · doi:10.1002/bimj.201800345 · Cited by 2 · see citing works
“In contrast, there was evidence supporting a nonzero LATE for two secondary outcomes, depression and social integration (Taylor et al., 2016).”
BackgroundSelf-citation
Enablers, Barriers and Practical Applications of a Group‐Based Pain Self‐Management Program for Patients Receiving Medical Cannabis: A Qualitative Study of Patients and Clinicians
Marom, P., Novak, A. M., Heruti, R. J., & Lev‐Ari, S. (2025) · Pain Practice · doi:10.1111/papr.70052 · Cited by 1 · see citing works
What does collaborative healthcare for people with musculoskeletal-related conditions look like? A scoping review
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Effectiveness and cost-effectiveness of a novel, group self-management course for adults with chronic musculoskeletal pain: study protocol for a multicentre, randomised controlled trial (COPERS)
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Novel three-day, community-based, nonpharmacological group intervention for chronic musculoskeletal pain (COPERS): a randomised clinical trial
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Pain management for chronic musculoskeletal conditions: the development of an evidence-based and theory-informed pain self-management course
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Optimization of a Self-management Program for Chronic Musculoskeletal Pain – Protocol of the Pain Education Program Optimization (PEPO) Randomized Controlled Trial
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Authors: Taylor, S. J., Carnes, D., Homer, K., Pincus, T., Kahan, B. C., Hounsome, N., Eldridge, S., Spencer, A., Diaz-Ordaz, K., Rahman, A., Mars, T. S., Foell, J., Griffiths, C. J., & Underwood, M. R.
Affiliations: Queen Mary University of London (GB)
Royal Holloway University of London (GB)
University of Exeter (GB)
Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
University College Hospital (GB)
University of Warwick (GB)
Corresponding author: Taylor, Stephanie JC
ORCID: Taylor, Stephanie JC
Carnes, Dawn
Pincus, Tamar
Kahan, Brennan C
Hounsome, Natalia
Eldridge, Sandra
Spencer, Anne
Rahman, Anisur
Foell, Jens
Griffiths, Chris J
Underwood, Martin R
Venue: Programme Grants for Applied Research
Publisher: National Institute for Health and Care Research
Published: 2016-09
Volume: 4
Issue: 14
Pages: 1-440
ISSN: 2050-4322 (ISSN-L)
2050-4330
DOI: 10.3310/pgfar04140
OpenAlex: W2521165122
Cited by: 44
References: 352
Citations by year: 2026: 1 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 1 · 2021: 6 · 2020: 4 · 2019: 6 · 2018: 6 · 2017: 3
FWCI: 4.05
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: www.nationalarchives.gov.uk/doc/non-commercial-government-licence/non-commercial-government-licence.htm (unspecified)
Locations: Programme Grants for Applied Research (publishedVersion)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Sussex Research Online (University of Sussex) (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Figshare (submittedVersion, cc-by)
Figshare (submittedVersion)
Open Research Exeter (University of Exeter) (submittedVersion)
Funders: National Institute for Health Research (RP-PG-0707-10189)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords: chronic musculoskeletal pain, self-management support, group intervention, pain-related disability, cost-effectiveness, pain acceptance, coping, anxiety and depression, self-efficacy, Bangladeshi community, primary care, physiotherapy, health care utilization, behaviour change theory, EQ-5D

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Improving the self-management of chronic pain: COping with persistent Pain, Effectiveness Research in Self-management (COPERS)

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