Expectations towards and effects of chronic pain self-management interventions at Healthy Life Centre in public primary care

Introduction: This abstract builds on a PhD-project conducted in the period 2015- 2018. Chronic pain affects a substantial portion of the global population. Due to the extensive impacts and prevalence of the condition, chronic pain is considered a public health challenge. Self-management interventions are important to empowering people with chronic pain so they can play an active role in managing their health. The Norwegian Healthy Life Centre (HLC) is a community-based public primary health care service that aims to provide easy access by accepting self-referrals for their services. However, there is limited knowledge on delivering easily accessible chronic pain self-management interventions in primary care. The objective of this project was to contribute knowledge related to the expectations towards and the effects that persons with chronic pain get from participating in self-management interventions at a HLC. Material and Methods: A qualitative interview study and a randomised controlled trial (RCT) were conducted. During the RCT, the intervention group was offered a group-based self-management course encompassing educational input, group discussions and movement exercises. The control group was offered a drop-in low impact physical activity in groups. Both activities had weekly sessions for a period of six weeks. The primary outcome in the RCT was patient activation and data were collected at three, six and twelve months. Analyses in the RCT were performed using a two-level linear mixed model. The qualitative study included individual semi-structured interviews at the baseline before randomisation with a sample of participants from the RCT. They were asked open-ended questions regarding their expectations towards participation in the HLC chronic pain self-management interventions. Results: A total of 121 participants were included in the RCT. Of these, 21 participated in the qualitative study. The expectations were based on the hope that the interventions could lead to a better everyday life. The course led to improvements in patient activation in the intervention group, and a decrease in pain that sustained throughout the follow-up period in both groups. Conclusions: Chronic pain self-management support interventions delivered in an easily accessible service are valuable for people in their efforts to self-manage chronic pain.