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Informal caregiver training for people with chronic pain in musculoskeletal services (JOINT SUPPORT): protocol for a feasibility randomised controlled trial

Informal caregiver training for people with chronic pain in musculoskeletal services (JOINT SUPPORT): protocol for a feasibility randomised controlled trial
Informal caregiver training for people with chronic pain in musculoskeletal services (JOINT SUPPORT): protocol for a feasibility randomised controlled trial

Introduction: chronic musculoskeletal (bone, joint or muscle) pain is disabling. People with it frequently have difficulties in managing everyday activities. Individuals may rely on family members or friends to support them. These people are known as informal caregivers. No interventions have previously addressed the health needs of people with chronic musculoskeletal pain and their caregivers. In response, the JOINT SUPPORT programme was developed. In this study, we will assess the feasibility and acceptability of conducting a pragmatic, multicentre, randomised controlled trial (RCT) to test the clinical and cost-effectiveness of the JOINT SUPPORT programme to support these individuals. 

Methods and analysis: this will be a mixed-methods feasibility RCT. We will recruit 80 patients with chronic musculoskeletal pain with their informal caregivers. Patients will be randomised to usual National Health Service (NHS) care OR usual NHS care plus a caregiver-patient dyad training programme (JOINT SUPPORT). This programme comprises of five, 1-hour, group-based sessions for patients and caregivers, delivered by trained physiotherapists or occupational therapists. It includes developing skills in: understanding pain, pacing, graded activity, fear avoidance and goal-setting, understanding benefits of physical activity and skills in medication management. This will be re-enforced with a workbook. After the group-based sessions, patients and caregivers will be supported through three telephone sessions with a therapist. Data collected at baseline and 3 months will include: screening logs, intervention logs, fidelity checklists and clinical outcomes on quality of life, physical and emotional outcomes, adverse events and resource use. Qualitative research with 24 patient-caregiver dyads and 12 healthcare professionals will explore the acceptability of trial processes. Stop-go criteria will inform the progression to a full trial. 

Ethics and dissemination: ethical approval was obtained on 22 February 2022 (National Research Ethics Committee Number: 22/NW/0015). Results will be reported at conferences, peer-review publications and across social media channels. Trial registration number ISRCTN78169443.

PAIN MANAGEMENT, REHABILITATION MEDICINE, RHEUMATOLOGY
2044-6055
e070865
Smith, Toby
548fc6f9-b2bf-43a5-9a1f-8a0a1a13ad9d
Khoury, Reema
3fb7fa1e-55da-4eac-9c97-6a7d4339d038
Ashford, Polly-anna
7dab6213-f267-4ae4-a683-3231b425cc57
Hanson, Sarah
df3791ba-32bf-4a5a-afc3-96380731e8c6
Welsh, Allie
c06b951f-928b-4cfb-b7ec-ef691c1b679e
Clark, Allan B.
a0642695-ec8d-4858-b5c3-c15da7c90398
Dures, Emma
feaebb8b-77b9-4041-9a16-15d312c5696b
Adams, Jo
8f43069d-7a0f-4a31-9544-1b5eed6ddb40
Adams, Joanna
6e38b8bb-9467-4585-86e4-14062b02bcba
Smith, Toby
548fc6f9-b2bf-43a5-9a1f-8a0a1a13ad9d
Khoury, Reema
3fb7fa1e-55da-4eac-9c97-6a7d4339d038
Ashford, Polly-anna
7dab6213-f267-4ae4-a683-3231b425cc57
Hanson, Sarah
df3791ba-32bf-4a5a-afc3-96380731e8c6
Welsh, Allie
c06b951f-928b-4cfb-b7ec-ef691c1b679e
Clark, Allan B.
a0642695-ec8d-4858-b5c3-c15da7c90398
Dures, Emma
feaebb8b-77b9-4041-9a16-15d312c5696b
Adams, Jo
8f43069d-7a0f-4a31-9544-1b5eed6ddb40
Adams, Joanna
6e38b8bb-9467-4585-86e4-14062b02bcba

Smith, Toby, Khoury, Reema, Ashford, Polly-anna, Hanson, Sarah, Welsh, Allie, Clark, Allan B., Dures, Emma, Adams, Jo and Adams, Joanna (2023) Informal caregiver training for people with chronic pain in musculoskeletal services (JOINT SUPPORT): protocol for a feasibility randomised controlled trial. BMJ Open, 13 (1), e070865. (doi:10.1136/bmjopen-2022-070865).

Record type: Article

Abstract

Introduction: chronic musculoskeletal (bone, joint or muscle) pain is disabling. People with it frequently have difficulties in managing everyday activities. Individuals may rely on family members or friends to support them. These people are known as informal caregivers. No interventions have previously addressed the health needs of people with chronic musculoskeletal pain and their caregivers. In response, the JOINT SUPPORT programme was developed. In this study, we will assess the feasibility and acceptability of conducting a pragmatic, multicentre, randomised controlled trial (RCT) to test the clinical and cost-effectiveness of the JOINT SUPPORT programme to support these individuals. 

Methods and analysis: this will be a mixed-methods feasibility RCT. We will recruit 80 patients with chronic musculoskeletal pain with their informal caregivers. Patients will be randomised to usual National Health Service (NHS) care OR usual NHS care plus a caregiver-patient dyad training programme (JOINT SUPPORT). This programme comprises of five, 1-hour, group-based sessions for patients and caregivers, delivered by trained physiotherapists or occupational therapists. It includes developing skills in: understanding pain, pacing, graded activity, fear avoidance and goal-setting, understanding benefits of physical activity and skills in medication management. This will be re-enforced with a workbook. After the group-based sessions, patients and caregivers will be supported through three telephone sessions with a therapist. Data collected at baseline and 3 months will include: screening logs, intervention logs, fidelity checklists and clinical outcomes on quality of life, physical and emotional outcomes, adverse events and resource use. Qualitative research with 24 patient-caregiver dyads and 12 healthcare professionals will explore the acceptability of trial processes. Stop-go criteria will inform the progression to a full trial. 

Ethics and dissemination: ethical approval was obtained on 22 February 2022 (National Research Ethics Committee Number: 22/NW/0015). Results will be reported at conferences, peer-review publications and across social media channels. Trial registration number ISRCTN78169443.

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More information

Accepted/In Press date: 10 January 2023
Published date: 27 January 2023
Additional Information: Funding Information: This study is funded by the National Institute for Health Research (NIHR) Research for Patient Benefit grant (NIHR202723). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. *Neither the funder or sponsor have ultimate authority over the analysis, interpretation, writing of reports or submission of publications. Publisher Copyright: © Author(s) (or their employer(s)) 2023.
Keywords: PAIN MANAGEMENT, REHABILITATION MEDICINE, RHEUMATOLOGY

Identifiers

Local EPrints ID: 475063
URI: http://eprints.soton.ac.uk/id/eprint/475063
ISSN: 2044-6055
PURE UUID: b59af4d0-fda8-41c9-8adc-e9e9b850033b
ORCID for Joanna Adams: ORCID iD orcid.org/0000-0003-1765-7060

Catalogue record

Date deposited: 09 Mar 2023 19:01
Last modified: 06 Jun 2024 01:35

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Contributors

Author: Toby Smith
Author: Reema Khoury
Author: Polly-anna Ashford
Author: Sarah Hanson
Author: Allie Welsh
Author: Allan B. Clark
Author: Emma Dures
Author: Jo Adams
Author: Joanna Adams ORCID iD

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