EAPER-P Early, accessible, person-centred rehabilitation for people with long-term pain

Chronic pain 

Long-term pain is a common reason for seeking medical care, the second most common cause of long-term sick leave. It leads to great personal suffering and extensive societal costs. Low confidence in their ability, anxiety, depression, stress, and sleep disorders are common in people with long-term pain.

Person centered care 

The current project is based on a person-centred ethic that intends to identify, confirm and utilize the person's own strengths and abilities, which are often underused resources in health care. Previous studies have shown that person-centred interventions increase confidence in one's own ability in combination with speedier return to work, reduced costs and increased health-related quality of life.

E-health 

E-health services can create conditions for learning, accessibility and knowledge translation in the event of illness and medical treatment. Furthermore, e-health services contribute to increased transparency and to breaking up traditional structures. It is important to develop e-health services based on a person-centered approach to identify and utilize patients' resources, meet needs and co-create care between patients, their relatives and health care professionals.

Purpose 

EAPER-P aims to investigate,  in a randomized controlled study, whether an early person-centred intervention in the home via telephone calls and an e-health platform is a cost-effective method to increase confidence in self-efficacy and increase return to work in case of prolonged pain compared to standard treatment. The project also includes qualitative studies on living with - and being on sick leave for long-term pain as well as a process and health economic evaluation of the intervention.

Method 

The project's design is a randomized, controlled intervention study of early person-centered intervention with 220 patients with chronic pain are recruited from primary care. EAPER-P acts as a support to manage their everyday life, anytime, anywhere, where patients, healthcare professionals, family, friends and employers can work together.

In addition to the traditional healthcare and treatments, the intervention group receives person-centred calls via telephone and access to a digital platform that has several functions that aim to make it easier for participants to manage their everyday lives. On the digital platform, participants can report and monitor their health status, take part in and co-create their health plan and continuously update it together with health care professionals. People who are important for their rehabilitation and recovery may also be included in this plan. EAPER-P is based on a person-centred, practical ethics and is unique in that it helps to identify and utilize the strengths and abilities of the individual and his or her social network. The project involves a simple intervention early in the course of the disease, where the patient has the main role in their own rehabilitation.

The project's qualitative studies, which aim to investigate what it is like to live and be on sick leave for long-term pain and what support people with long-term pain need, will collect data using interviews with people living with long-term pain. Process evaluations will be conducted with data from the intervention and analyzed together with interviews with the participants in the intervention. The health economic evaluations will be conducted using registry data from the Västra Götaland Region regarding healthcare consumption

Expected results

The person-centered intervention is expected to facilitate rehabilitation and recovery for people who are on sick leave for long-term pain and lead to strengthened self-esteem, increased return to work and lower social costs. The results are also expected to generate knowledge about how and in what way person-centered care via a combined e-health and telephone support can be effective. The qualitative studies are expected to lead to increased knowledge about what it is like to live with long-term pain and what support these people's needs. 

Project status 

The recruitment and intervention has been completed, and initial results are expected in the fall of 2024. Both the process evaluation and the economic evaluation are ongoing, with expected results in the fall of 2024 and the spring of 2025, respectively

Publications 

• Balancing between being the most valuable player (MVP) and passing the ball: a qualitative study of support when living with chronic pain in Swedenhttps://gup.ub.gu.se/publication/335611
• Suffering out of sight but not out of mind - interpreting experiences of sick leave due to chronic pain in a community setting: a qualitative studyhttps://gup.ub.gu.se/publication/325531