Aggarwal, VR orcid.org/0000-0003-0838-9682, Wu, J orcid.org/0000-0001-6093-599X, Fox, F et al. (3 more authors) (2021) Implementation of biopsychosocial supported self-management for chronic primary oro-facial pain including temporomandibular disorders: A theory, person and evidence-based approach. Journal of Oral Rehabilitation, 48 (10). pp. 1118-1128. ISSN 0305-182X
Abstract
Background
Aims of the study were to:
Implement supported self-management for chronic primary oro-facial pain in a clinical setting.
Evaluate its impact on consultation rates, pain severity, interference with life and patient experience.
Methods
Sixty-six patients with chronic primary oro-facial pain received the intervention at a facial pain clinic at Leeds Dental Institute, UK. Brief Pain Inventory (BPI) scores measured pain severity and interference with life before and after the intervention. Process mining outlined patient care pathways. Monthly consultation rates measured 12 months before and after the intervention were used to evaluate burden on healthcare services and economic impact. Patient feedback was assessed via Patient and Public involvement discussion groups.
Results
Mean BPI scores significantly improved after intervention—from 5.70 (SD 1.89) to 3.78 (SD 2.34) (p < .001); mean pain interference score reduced from 19.95 (SD 9.41) to 12.05 (SD 9.64) (p < .001). Average monthly consultations significantly (p = .001) reduced from 0.42/month before the intervention to 0.16/month after the intervention. Economic assessment showed cost savings of £293 per patient per year. Process mining showed high rates of service usage with 31 patients also attending 51 other specialist services between them. Patient and Public Involvement discussion groups with 5 patients identified that the intervention was a ‘constant companion’ and should be implemented at the outset in the care pathway.
Conclusion
Supported self-management for chronic primary oro-facial pain has a positive impact on health outcomes (physical functioning, pain intensity and patient experience), as well as service usage and healthcare costs when implemented in a secondary care clinical setting. Reconfiguring current care pathways to upscale early implementation of such interventions should be a priority for future testing.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Aggarwal, VR, Wu, J, Fox, F, Howden, D, Guthrie, E, Mighell, A. Implementation of biopsychosocial supported self-management for chronic primary oro-facial pain including temporomandibular disorders: A theory, person and evidence-based approach. J Oral Rehabil. 2021; 48: 1118– 1128, which has been published in final form at https://doi.org/10.1111/joor.13229. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
Keywords: | biopsychosocial; burning mouth syndrome; chronic oro-facial pain; Self-management; Temporomandibular disorders |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Applied Health and Clinical Translation (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Oral Surgery (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 01 Jul 2021 12:51 |
Last Modified: | 17 Jul 2022 00:13 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/joor.13229 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:175711 |