A cohort study currently in press at the International Journal of Osteopathic Medicine by Abbey et al. assessed the effect of a multimodal and psychologically-informed pain self-management course that was delivered by osteopaths and combined manual treatment (informed by the biopsychosocial model) with psychological and mindfulness-informed interventions (focused on pain acceptance) for patients with persistent musculoskeletal pain (being highly comorbid with anxiety and depression). The authors assessed (1) quality of life, (2) pain coping, (3) psychological inflexibility, and (4) mindfulness, alongside (5) qualitative assessments of (a) patient satisfaction, (b) adverse reactions, and (c) medication changes. 256 patients participated and self-report data were assessed at baseline (n=180) and after six months (n=79). Outcomes improved significantly showing (1) an increase in quality of life, (2) an increase in pain coping, (3) a decrease in psychological inflexibility, and (4) an increase in mindfulness measures. Furthermore, (5) qualitative assessments showed that (a) 95% of the participants were ‘satisfied’ or ‘very satisfied’ with the course, (b) no serious adverse events were reported, and (c) 42% of the participants reported less medication use at six months, while 23% reported more. In sum, increased psychological flexibility and mindfulness were associated with increased quality of life and pain coping. Overall, the psychologically-informed self-management course delivered by osteopaths for patients with persistent pain was feasible and supported by patient outcomes. Future pragmatic randomised controlled trials and the development of multimodal models were recommended.
Abbey, H., Nanke, L., Brownhill, K., in Press. Developing a psychologically-informed pain management course for use in osteopathic practice: The OsteoMAP cohort study. International Journal of Osteopathic Medicine.