The utilization patterns and impact of the Stanford Chronic Pain Self-Management Program in Eastern Ontario, Canada

Context Healthcare providers often struggle to treat patients with chronic pain. One potential solution is to facilitate patient access to programs that develop skills and confidence in managing their own care.

Objectives: In this study, we aimed to describe patterns of utilization of a Chronic Pain Self-Management Program (CPSMP) in Eastern Ontario and evaluate the impact of the program on patient activation, a measure of participants’ involvement in their care, their health behaviors, and their knowledge of the condition.

Study design and analysis: We conducted descriptive analysis of the number of participants registered each year, their gender and age distributions. We conducted longitudinal analyses of change in patient activation between participants’ enrollment in the program (baseline) and the end of the program (follow-up).

Dataset: We used data routinely collected through the CPSMP between December 2017 and May 2023.

Population studied: The CPSMP targeted individuals suffering from chronic pain in the Champlain region of Eastern Ontario. Anyone suffering from pain could register for the program without needing a referral or formal diagnosis from a health care practitioner.

Intervention: The CPSMP is a six-week, peer-led program based on self-efficacy theory. The program explores themes such as sleep, managing difficult emotions, exercise, relaxation techniques, decision-making, problem-solving, and creating concrete action plans.

Outcome Measures: Patient activation, measured via the validated Patient Activation Measure

Results: 1023 individuals participated in the CPSMP during the study period. The number of participants peaked in 2018 and remained stable thereafter. There was a higher proportion of female (69%, n=709) compared to male participants and a higher proportion of 50-59-year-olds, compared to other age groups. Among the 151 participants (15% of the total sample) who completed a PAM survey at baseline and follow-up, 69% (104/151) experienced a clinically meaningful increase of four points on the PAM scale.

Conclusions: Participation in the CPSMP resulted in a clinically meaningful increase in patient activation among patients with chronic pain. Since only 15% of CPSMP participants completed the PAM survey at baseline and follow-up, replication in a larger sample is warranted.