Research project proposal

Abstract image of curvy lines. Research project proposal.

Abstract image of curvy lines. Telehealth multidisciplinary pain management program for people with persistent musculoskeletal pain.

Shaded overlay. X Ray image of patient who have shoulder pain isolated on white background, space for your message and idea medical concept X Ray image of patient who have shoulder pain isolated on white background, space for your message and idea medical concept chronic pain stock pictures, royalty-free photos & images.

Shaded overlay. Background. One of the major healthcare problems in Australia (Australian Institute of Health and Welfare, 2020). The chronic pain service dramatically changed due to Covid – 19 (Fallon et al., 2020).

Background. 37 310 Back Pain Stock Photos Pictures Royalty Free Images iStock.

Chronic pain. The chronic pain is defined as ‘an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage’ (Raja et al., 2020, p. 1977). The International Classification of Diseases 11 th revision (ICD-11) (2019) classification of chronic pain is located under section MG30, and it is used if the pain condition persists or recurs for more than three months..

Chronic pain. Mental health problems and psychological distress are very common among patients with chronic pain ( Gatchel , 2004; Goesling et al., 2018; Lerman et al., 2015). Psychological issues can impact on the risk of developing chronic pain ( Gerrits et al., 2015). All areas of life are impacted by chronic pain ( Hadi et al., 2019)..

rationale. Lack of available data and few research studies conducted so far that compare telehealth and face-to-face consultations in patients with persistent musculoskeletal pain (Williams et al., 2021). Development of clinical guidelines for telehealth consultations when treating patients with persistent musculoskeletal pain..

rationale. Lack of available studies research related to Covid-19 pandemic telehealth interdisciplinary pain management program and all components of the program across medical, physiotherapy and psychology consultations especially in Australia. No long-term outcomes associated with telehealth-delivered pain management compared to face-to-face delivery in people with persistent musculoskeletal pain..

rationale. Benefits for people living in remote and rural regions of Australia..

Aims of the research. To determine if telehealth psychology consultations in multidisciplinary pain management program are comparable to face-to-face consultations for patients with persistent musculoskeletal pain..

hypotheses. Telehealth psychology consultations in multidisciplinary pain management program are comparable to face-to-face psychology consultations for patient with persistent musculoskeletal pain. No significant difference will be found in DASS-21, PSEQ, PCS, ISI, PCL-5 and PBAS outcome scores for patients attending telehealth psychology consultations and face-to-face psychology consultations considering percentage in both types of consultations at initial and discharge assessments. No significant difference will be found in DASS-21, PSEQ, PCS, ISI, PCL-5 and PBAS outcome scores for patients attending telehealth psychology consultations and face-to-face psychology consultations considering percentage in both types of consultations at initial and follow up assessments (after six months from initial assessments)..

Project design. This is the observational retrospective study that will use the existing de-identified database of Advance Healthcare Clinics in Melbourne related to patients with persistent musculoskeletal pain who attended the interdisciplinary pain management program during the Covid-19 pandemic. The project is conducted in collaboration with La Trobe University..

Project design. All patients in the study completed initial ePPOC (Establishment of the Australasian Electronic Persistent Pain Outcomes Collaboration) questionnaires at three stages: During the initial assessment for the program During the discharge session Six months after discharge during the follow up session (Tardif et al., 2017)..

Project design. Advance Healthcare electronic de-identified database will be provided to La Trobe University. This is an existing database for patients attended multidisciplinary pain management program from March 2020 until March 2022 including follow up review after six months. Data will be transferred securely from Advance Healthcare to the La Trobe University researchers via the CloudStor FileSender tool..

Project design. During this period, the amount of telehealth received by patients versus face-to-face consultations varied for each patient, enabling analysis to determine whether treatment outcomes vary with the degree of telehealth..

Measurements. The Depression Anxiety Stress Scale (DASS-21, Lovibond & Lovibond, 1995) is a quantitative psychological measure of depression, anxiety and stress. The cutoff scores developed for DASS-21 define mild, moderate, severe and extremely severe scores for each DASS subscale. The Pain Catastrophizing Scale (PCS, Sullivan et al., 1995) is a psychological instrument measuring catastrophic thinking related to pain where patients need to answer about how they feel and what thoughts they have when they are in pain. The PCS measures rumination, magnification and helplessness. The cutoff scores define pain catastrophising into categories of low, moderate or high. The Pain Self-Efficacy Questionnaire (PSEQ, Nicholas, 2007) is questionnaire that assesses confidence in people with chronic pain when they perform daily activities despite their pain. The levels of confidence are defined as low, moderate and high..

Measurements. The Pain-Related Beliefs and Attitude about Sleep Scale (PBAS, Afolalu et al., 2016) is a questionnaire designed to measure patients’ beliefs about the interaction between sleep and pain. The patients’ beliefs can be categorised as normal, moderate or severe. The Insomnia Severity Index (ISI, Morin et al., 2011) is a short questionnaire assessing the severity, nature and impact of insomnia in the last month. The PTSD Checklist – Civilian Version (PCL-5, Weathers et al., 1991) is a self-report measure that includes 20 items that reflect the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for PTSD. A cut-off score of 31 is stated to be the best screen for PTSD..

participants. 194 adult patients aged between 18 to 76 with persistent musculoskeletal pain symptoms..

Inclusion criteria. Patients will be included in the database if they met the following criteria: 1. Patients will chronic persistent musculoskeletal pain and have attended multidisciplinary pain management program (any combination of face-to-face and telehealth). 2. Aged between 18 to 76 years 3. Sufficient fluency in English to complete the outcome measures independently, or alternatively via an interpreter..

exclusion criteria. Exclusion criteria Patients without six month follow up data completed Patients outside of the multidisciplinary pain management program.

Research design. This is the observational retrospective study that will use the existing de-identified database of Advance Healthcare related to patients with persistent musculoskeletal pain who attended the interdisciplinary pain management program during the Covid-19 pandemic..

Statistical analysis. Sample Size: Justify the intended sample size to meet the aims of the project http://powerandsamplesize.com/Calculators/ (quantitative sample size calculator) http://stat.ubc.ca/~rollin/stats/ssize/index.html (quantitative sample size calculator) The total of 194 patients would enable a small correlation (between proportion of telehealth and clinical outcomes) of 0.2 to be detected with 80% power (alpha set at p=0.05) (Kohn & Senyak , 2021) Microsoft Excel and IBM SPSS will be used for analyses. Clinical outcomes will be extracted along with the proportion of telehealth for each patient. Multiple regression analysis will be run to determine the association between the proportion of telehealth received and clinical outcomes, adjusting for other prognostic information such as pain location, pain type, gender, age, work status and duration of symptoms..

Shaded overlay. Expected outcome. To confirm there is no difference in outcome scores for telehealth and face-to-face psychological consultations in patients with persistent musculoskeletal pain..

references. Afolalu , E. F., Moore, C., Ramlee , F., Goodchild, C. E., & Tang, N. K. (2016). Development of the Pain-Related Beliefs and Attitudes about Sleep (PBAS) Scale for the Assessment and Treatment of Insomnia Comorbid with Chronic Pain. Journal of Clinical Sleep Medicine, 12 (9), 1269–1277. https://doi.org/10.5664/jcsm.6130 Anagnostis , C., Gatchel , R. J., & Mayer, T. G. (2004). The pain disability questionnaire: a new psychometrically sound measure for chronic musculoskeletal disorders. Spine , 29 (20), 2290–2303. https://doi.org/10.1097/01.brs.0000142221.88111.0f Australian Institute of Health and Welfare. (2020). Chronic Pain in Australia (No. PHE 267). https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx?inline=true Bennett, M. I., Smith, B. H., Torrance, N., & Potter, J. (2005). The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. The Journal of Pain , 6 (3), 149–158. https://doi.org/10.1016/j.jpain.2004.11.007 Berman, A. H., Bergman, H., Palmstierna , T., & Schlyter , F. (2005). Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample. European Addiction Research , 11 (1), 22–31. https://doi.org/10.1159/000081413 Berryhill, M. B., Halli -Tierney, A., Culmer , N., Williams, N., Betancourt, A., King, M., & Ruggles, H. (2019). Videoconferencing psychological therapy and anxiety: a systematic review. Family Practice , 36 (1), 53–63. https://doi.org/10.1093/fampra/cmy072 Booth, G., Williams, D., Patel, H., & Gilbert, A. W. (2021). What is the content of virtually delivered pain management programmes for people with persistent musculoskeletal pain? A systematic review. British Journal of Pain . https://doi.org/10.1177/20494637211023074 Bradley, K. A., DeBenedetti , A. F., Volk, R. J., Williams, E. C., Frank, D., & Kivlahan , D. R. (2007). AUDIT-C as a brief screen for alcohol misuse in primary care. Alcoholism, Clinical and Experimental Research , 31 (7), 1208–1217. https://doi.org/10.1111/j.1530-0277.2007.00403.x Bradley, K. E., Cook, C., Reinke, E. K., Vinson, E. N., Mather, R. C., 3rd, Riboh , J., Lassiter, T., & Wittstein , J. R. (2020). Comparison of the accuracy of telehealth examination versus clinical examination in the detection of shoulder pathology. Journal of Shoulder and Elbow Surgery , 30 (5), 1042–1052. https://doi.org/10.1016/j.jse.2020.08.016 Chen, C. K., Palfrey, A., Shreck , E., Silvestri, B., Wash, L., Nehrig , N., . . . Chodosh, J. (2019). Implementation of Telemental Health (TMH) psychological services for rural veterans at the VA New York Harbor Healthcare System. Psychological Services . Advance online publication. http://dx.doi.org/10.1037/ser0000323 Cleeland , , C. S. (1991). The brief pain inventory: user guide. Retrieved November 28, 2021, from https://www.mdanderson.org/documents/Departments-and-Divisions/Symptom-Research/BPI_UserGuide.pdf ePPOC Clinical Reference Manual. Australian Version 2 Dataset (2021). University of Wollongong: Australian Health Services Research Institute. EuroQol Research Foundation. EQ-5D-5L User Guide, 2019. Available from: https://euroqol.org/publications/user-guides Fallon, N., Brown, C., Twiddy , H., Brian, E., Frank, B., Nurmikko , T., & Stancak , A. (2020). Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain. British Journal of Pain , 15 (3), 357–368. https://doi.org/10.1177/2049463720973703 Gardner-Nix, J., Barbati , J., Grummitt, J., Pukal , S., & Raponi Newton, R. (2014). Exploring the Effectiveness of a Mindfulness-Based Chronic Pain Management Course Delivered Simultaneously to On-Site and Off-Site Patients Using Telemedicine. Mindfulness, 5 , 223-231. https://doi.org/10.1007/s12671-012-0169-3 Haider, Z., Aweid , B., Subramanian, P., & Iranpour , F. (2020). Telemedicine in orthopaedics and its potential applications during COVID-19 and beyond: A systematic review. Journal of Telemedicine and Telecare , 1357633X20938241. Advance online publication. https://doi.org/10.1177/1357633X20938241 Bottom of Form IBM Corp. (2017). IBM SPSS Statistics for Windows . Armonk, NY: IBM Corp. Retrieved November 28, 2021 from https://hadoop.apache.org Kirwan, R., McCullough, D., Butler, T., Perez de Heredia, F., Davies, I. G., & Stewart, C. (2020). Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience , 42 (6), 1547–1578. https://doi.org/10.1007/s11357-020-00272-3.

references. Kohn, m. A., & Senyak , J. Sample Size Calculators [https://sample- size.net /all-calculators-on-this-site/]. UCSF CTSI. 8 August 2021. Available at https://sample-size.net/all-calculators-on-this-site/ [Accessed 28 December 2021] Krause, S. J., & Backonja , M. M. (2003). Development of a neuropathic pain questionnaire. The Clinical Journal of Pain , 19 (5), 306–314. https://doi.org/10.1097/00002508-200309000-00004 Lafontaine, M.F., Azzi , S., Paquette, D., Tasca , G., Greenmand , P.S., Gosselin, J., Lebel, S., & Grenier , J. (2018). Telehealth for Patients with Chronic Pain: Exploring a Successful and an Unsuccessful Outcome. Journal of Technology in Human Services, 36 , 140 - 160. https://doi.org/10.1080/15228835.2018.1491370 Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Psychology Foundation of Australia. Mesa- Castrillon , C.I., Simic , M., Ferreira, M.L. et al. (2021). EHealth to empower patients with musculoskeletal pain in rural Australia ( EMPoweR ) a randomised clinical trial: study protocol. BMC Musculoskeletal Disorders 22, ( 11). https://doi.org/10.1186/s12891-020-03866-2 Morin, C. M., Belleville, G., Bélanger , L., & Ivers , H. (2011). The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep , 34 (5), 601–608. https://doi.org/10.1093/sleep/34.5.601 Neblett , R., Cohen, H., Choi, Y., Hartzell, M. M., Williams, M., Mayer, T. G., & Gatchel , R. J. (2013). The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. The Journal of Pain , 14 (5), 438–445. https://doi.org/10.1016/j.jpain.2012.11.012 Nicholas M. K. (2007). The pain self-efficacy questionnaire: Taking pain into account. European Journal of Pain, 11 (2), 153–163. https://doi.org/10.1016/j.ejpain.2005.12.008 Sullivan, M. J. L., Bishop, S. R., & Pivik , J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7 (4), 524–532. https://doi.org/10.1037/1040-3590.7.4.524 Tardif, H., Arnold, C., Hayes, C., & Eagar, K. (2017). Establishment of the Australasian Electronic Persistent Pain Outcomes Collaboration. Pain Medicine, 18 (6), 1007–1018. https://doi.org/10.1093/pm/pnw201 Weathers, F. W., Huska , J.A., & Keane,T . M. (1991). PCL-C for DSM-IV. National Center for PTSD - Behavioral Science Division. Westman, A., Linton, S. J., Ohrvik , J., Wahlén , P., & Leppert , J. (2008). Do psychosocial factors predict disability and health at a 3-year follow-up for patients with non-acute musculoskeletal pain? A validation of the Orebro Musculoskeletal Pain Screening Questionnaire. European Journal of Pain , 12 (5), 641–649. https://doi.org/10.1016/j.ejpain.2007.10.007 Williams, D., Booth, G., Cohen, H., Gilbert, A., Lucas, A., Mitchell, C., Mittal, G., Patel, H., Peters, T., Phillips, M., Rudge, W., & Zarnegar , R. (2021). Rapid design and implementation of a virtual pain management programme due to COVID-19: a quality improvement initiative. British Journal of Pain . https://doi.org/10.1177/20494637211039252.

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