A pilot trial investigating the feasibility of a future randomised controlled trial of Individualised Placement and Support for people unemployed with chronic pain recruiting in primary care
A pilot trial investigating the feasibility of a future randomised controlled trial of Individualised Placement and Support for people unemployed with chronic pain recruiting in primary care
Background: We investigated the feasibility of recruiting patients unemployed for more than 3 months with chronic pain using a range of methods in primary care in order to conduct a pilot trial of Individual Placement and Support (IPS) to improve quality of life outcomes for people with chronic pain.
Methods: This research was informed by people with chronic pain. We assessed the feasibility of identification and recruitment of unemployed patients; the training and support needs of employment support workers to integrate with pain services; acceptability of randomisation, retention through follow-up and appropriate outcome measures for a definitive trial. Participants randomised to IPS received integrated support from an employment support worker and a pain occupational therapist to prepare for, and take up, a work placement. Those randomised to Treatment as Usual (TAU) received a bespoke workbook, delivered at an appointment with a research nurse not trained in vocational rehabilitation.
Results: Using a range of approaches, recruitment through primary care was difficult and resource-intensive (1028 approached to recruit 37 eligible participants). Supplementing recruitment through pain services, another 13 people were recruited (total n = 50). Randomisation to both arms was acceptable: 22 were allocated to IPS and 28 to TAU. Recruited participants were generally not 'work ready', particularly if recruited through pain services.
Conclusion: A definitive randomised controlled trial is not currently feasible for recruiting through primary care in the UK. Although a trial recruiting through pain services might be possible, participants could be unrepresentative in levels of disability and associated health complexities. Retention of participants over 12 months proved challenging, and methods for reducing attrition are required. The intervention has been manualised.
chronic pain, pilot, quality of life, recruitment, vocational rehabilitation
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Fraser, Simon D.S.
cc957f43-667a-4721-9398-e897b0e3485e
Price, Catherine
eb31ed10-87e0-48ea-b262-14f4f3a8fa52
Maguire, Nick
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Madan, Ira
c6fd0de4-6d73-47eb-9e97-79a2941c8767
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Linaker, Catherine
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
22 July 2022
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Fraser, Simon D.S.
cc957f43-667a-4721-9398-e897b0e3485e
Price, Catherine
eb31ed10-87e0-48ea-b262-14f4f3a8fa52
Maguire, Nick
ebc88e0a-3c1e-4b3a-88ac-e1dad740011b
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Madan, Ira
c6fd0de4-6d73-47eb-9e97-79a2941c8767
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Linaker, Catherine
6c6d1b90-ee40-4c96-8b2e-b06efbe030ae
Walker-Bone, Karen, Fraser, Simon D.S., Price, Catherine, Maguire, Nick, Cooper, Cyrus, Madan, Ira, Ntani, Georgia and Linaker, Catherine
(2022)
A pilot trial investigating the feasibility of a future randomised controlled trial of Individualised Placement and Support for people unemployed with chronic pain recruiting in primary care.
Primary Health Care Research & Development, 23, [e39].
(doi:10.1017/S1463423622000342).
Abstract
Background: We investigated the feasibility of recruiting patients unemployed for more than 3 months with chronic pain using a range of methods in primary care in order to conduct a pilot trial of Individual Placement and Support (IPS) to improve quality of life outcomes for people with chronic pain.
Methods: This research was informed by people with chronic pain. We assessed the feasibility of identification and recruitment of unemployed patients; the training and support needs of employment support workers to integrate with pain services; acceptability of randomisation, retention through follow-up and appropriate outcome measures for a definitive trial. Participants randomised to IPS received integrated support from an employment support worker and a pain occupational therapist to prepare for, and take up, a work placement. Those randomised to Treatment as Usual (TAU) received a bespoke workbook, delivered at an appointment with a research nurse not trained in vocational rehabilitation.
Results: Using a range of approaches, recruitment through primary care was difficult and resource-intensive (1028 approached to recruit 37 eligible participants). Supplementing recruitment through pain services, another 13 people were recruited (total n = 50). Randomisation to both arms was acceptable: 22 were allocated to IPS and 28 to TAU. Recruited participants were generally not 'work ready', particularly if recruited through pain services.
Conclusion: A definitive randomised controlled trial is not currently feasible for recruiting through primary care in the UK. Although a trial recruiting through pain services might be possible, participants could be unrepresentative in levels of disability and associated health complexities. Retention of participants over 12 months proved challenging, and methods for reducing attrition are required. The intervention has been manualised.
Text
FINAL accepted 19.5.22
- Accepted Manuscript
More information
Accepted/In Press date: 15 May 2022
e-pub ahead of print date: 22 July 2022
Published date: 22 July 2022
Additional Information:
Funding Information:
We are grateful to the National Institute for Health Research Health Technology Assessment Programme for funding this research (15/108/02). The authors would also like to thank Emeritus Professor David Coggon for his intellectual contribution to the original application, throughout the project and this manuscript. We are grateful to the staff from the Wessex Clinical Research Network who helped publicise the study and the staff of the nine practices who assisted with recruitment in primary care. We are very grateful to the employment teams of Southampton City Council and Portsmouth City Council and all those involved with the Solent Jobs Programme which enabled provision of IPS for this research, particularly Kathryn Rankin and Liz Crate. We would like to thank the Employment Support Workers who supported the IPS clients and the participants who took part in this research. We thank Vanessa Cox and Ken Cox for their support with data entry and cleaning and the University of Southampton for sponsorship.
Publisher Copyright:
©
Keywords:
chronic pain, pilot, quality of life, recruitment, vocational rehabilitation
Identifiers
Local EPrints ID: 467367
URI: http://eprints.soton.ac.uk/id/eprint/467367
ISSN: 1463-4236
PURE UUID: 1e564ac4-b409-4897-86fb-4be3446debc8
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Date deposited: 07 Jul 2022 16:57
Last modified: 09 Nov 2024 02:34
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Contributors
Author:
Simon D.S. Fraser
Author:
Catherine Price
Author:
Ira Madan
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