Ignite Creation Date:
2024-05-06 @ 8:12 PM
Last Modification Date:
2024-10-26 @ 3:23 PM
Study NCT ID:
NCT06297447
Status:
RECRUITING
Last Update Posted:
2024-03-13
First Post:
2024-02-29
Brief Title:
Keeping it Simple Study KISS
Sponsor:
Bettina Eiger
Organization:
Aalborg University
Study Overview
Official Title:
Keeping It Simple Study KISS - Pain Science Education for Patients With Chronic Musculoskeletal Pain Undergoing Community-based Rehabilitation A Multicenter Randomized Controlled Trial
Status:
RECRUITING
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
KISS
Brief Summary:
Problem The number of patients living with chronic musculoskeletal MSK pain has steadily increased over the past decade with costs rising equally Long-standing pain is associated with significant maladaptive beliefs about pain psychological characteristics and associated behaviors which involve structural and functional neurobiological characteristics which share common pathophysiological mechanisms as chronic pain The investigators recent priority setting partnership investigated the research priorities from 1000 patients with chronic MSK pain relatives and clinicians Better pain education was rated as one of the three most important research areas
Solution Pain science education has the potential to target maladaptive psychological and behavioral components that may contribute to the maintenance of chronic pain The KISS project will evaluate the effect of a pain neuroscience education program PNE4Adults on rehabilitation outcomes in patients with chronic MSK pain This intervention has the potential to change beliefs and behaviors surrounding pain in patients with chronic MSK pain If this is successful in disrupting maladaptive cycles contributing to chronicity this may improve outcomes for many thousand citizens
Solution Pain science education has the potential to target maladaptive psychological and behavioral components that may contribute to the maintenance of chronic pain The KISS project will evaluate the effect of a pain neuroscience education program PNE4Adults on rehabilitation outcomes in patients with chronic MSK pain This intervention has the potential to change beliefs and behaviors surrounding pain in patients with chronic MSK pain If this is successful in disrupting maladaptive cycles contributing to chronicity this may improve outcomes for many thousand citizens
Detailed Description:
Introduction Between 20 and 33 of people across the globe live with a painful musculoskeletal MSK condition Costs correspond to almost 2 of the gross domestic products of European countries posing a challenge for health care systems across the world Patients with chronic musculoskeletal pain have a high use of healthcare reduced work ability loss of productivity and loss of quality of life Current care guidelines underline that pain science education PSE is a vital part of the care delivered to people suffering from chronic pain PSE is thought in part to attenuate central sensitization and improve self-efficacy potentially mediated through decreased pain catastrophizing and modulating nocebo-related effects On a patient level PSE has been shown to reduce pain catastrophizing pain intensity and fear-avoidance in addition to improved physical functioning self-efficacy and pain knowledge Combining exercise and PSE shows greater short-term improvements in pain disability kinesiophobia and pain catastrophizing compared to exercise alone and the RESTORE-trial showed the benefit of adding cognitive components On a societal level PSE has further shown to minimize health expenses However some of the proposed barriers include training of the therapist delivering the education access to training material time during consultation and patients health literacy levels Even in Denmark a country with a highly educated population the prevalence of people with inadequate health literacy is high with nearly 4 out of 10 people facing difficulties accessing understanding appraising and applying health information This underlines the need to consider novel ways of delivering PSE across all levels of health literacy
Due to the lack of tools to facilitate PSE programs the investigators adapted an existing pain science education program that was developed by Pas et al 2018 PNE4Kids to teach children with chronic pain about the underlying biopsychosocial mechanisms contributing to pain The adapted version named PNE4Adults consists of a manual for the therapist and a board game to enhance engagement and participant involvement It provides the therapist with a clear how-to manual and an accessible way for patients to understand the complex concept of pain This new PSE program may also hold promise for adult patients with low levels of health literacy and enhance learning due to its practical tools and build-in teach-back The focus on integrating PSE into rehabilitation may enhance the therapeutic alliance needed to facilitate the patients ability to manage their own symptoms The investigators feasibility study in adult patients with chronic MSK pain in community-based rehabilitation Eiger Rathleff et al 2024 - under review showed that PNE4Adults was well accepted 100 and understandable by all 100 patients including those with low levels of health literacy Qualitive interviews revealed that patients irrespective of their health literacy acquired a deeper understanding of their own situation and their pain This novel approach may reduce the inequality in delivering of pain education
Purpose of Sub-project 1 The primary aim of the KISS-project is to evaluate the added effect of PSE PNE4Adults to usual care compared to usual care alone in community-based rehabilitation
The investigators hypothesis is PSE plus usual care will result in a larger improvement of musculoskeletal health MSK-HQ after 3 months primary endpoint compared to patients undergoing usual care in the municipality
Purpose of Sub-project 2 The secondary aim is to use a process evaluation to understand how it works and for whom the program works
The purpose of the process evaluation is to understand how it worked and for whom and not if it worked The investigators will combine in-house registrations from the municipality clinician observations individual interviews and focus-group interviews to answer what works for whom and under which circumstances This will give the investigators additional insights into the novel PSE intervention shedding light on how it induces change and uncovering any potential unintended consequences This will support future implementation pending results
Due to the lack of tools to facilitate PSE programs the investigators adapted an existing pain science education program that was developed by Pas et al 2018 PNE4Kids to teach children with chronic pain about the underlying biopsychosocial mechanisms contributing to pain The adapted version named PNE4Adults consists of a manual for the therapist and a board game to enhance engagement and participant involvement It provides the therapist with a clear how-to manual and an accessible way for patients to understand the complex concept of pain This new PSE program may also hold promise for adult patients with low levels of health literacy and enhance learning due to its practical tools and build-in teach-back The focus on integrating PSE into rehabilitation may enhance the therapeutic alliance needed to facilitate the patients ability to manage their own symptoms The investigators feasibility study in adult patients with chronic MSK pain in community-based rehabilitation Eiger Rathleff et al 2024 - under review showed that PNE4Adults was well accepted 100 and understandable by all 100 patients including those with low levels of health literacy Qualitive interviews revealed that patients irrespective of their health literacy acquired a deeper understanding of their own situation and their pain This novel approach may reduce the inequality in delivering of pain education
Purpose of Sub-project 1 The primary aim of the KISS-project is to evaluate the added effect of PSE PNE4Adults to usual care compared to usual care alone in community-based rehabilitation
The investigators hypothesis is PSE plus usual care will result in a larger improvement of musculoskeletal health MSK-HQ after 3 months primary endpoint compared to patients undergoing usual care in the municipality
Purpose of Sub-project 2 The secondary aim is to use a process evaluation to understand how it works and for whom the program works
The purpose of the process evaluation is to understand how it worked and for whom and not if it worked The investigators will combine in-house registrations from the municipality clinician observations individual interviews and focus-group interviews to answer what works for whom and under which circumstances This will give the investigators additional insights into the novel PSE intervention shedding light on how it induces change and uncovering any potential unintended consequences This will support future implementation pending results
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None