Informal caregiver training for people with chronic pain in musculoskeletal services (JOINT SUPPORT): protocol for a feasibility randomised controlled trial

Toby Smith; Reema Khoury; Polly-Anna Ashford; Sarah Hanson; Allie Welsh; Allan B Clark; Emma Dures; Jo Adams

doi:10.1136/bmjopen-2022-070865

Informal caregiver training for people with chronic pain in musculoskeletal services (JOINT SUPPORT): protocol for a feasibility randomised controlled trial

BMJ Open. 2023 Jan 27;13(1):e070865. doi: 10.1136/bmjopen-2022-070865.

Authors

Toby Smith^{1

2}, Reema Khoury², Polly-Anna Ashford², Sarah Hanson², Allie Welsh³, Allan B Clark², Emma Dures^{4

5}, Jo Adams^{2

6}

Affiliations

¹ Warwick Medical School, University of Warwick, Coventry, UK toby.o.smith@warwick.ac.uk.
² Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK.
³ School of Education, University of East Anglia, Norwich, UK.
⁴ School of Health and Social Wellbeing, University of the West of England, Bristol, UK.
⁵ Academic Rheumatology, Bristol Royal Infirmary, Bristol, UK.
⁶ School of Health Sciences, University of Southampton, Southampton, Hampshire, UK.

Abstract

Introduction: Chronic musculoskeletal (bone, joint or muscle) pain is disabling. People with it frequently have difficulties in managing everyday activities. Individuals may rely on family members or friends to support them. These people are known as informal caregivers. No interventions have previously addressed the health needs of people with chronic musculoskeletal pain and their caregivers. In response, the JOINT SUPPORT programme was developed. In this study, we will assess the feasibility and acceptability of conducting a pragmatic, multicentre, randomised controlled trial (RCT) to test the clinical and cost-effectiveness of the JOINT SUPPORT programme to support these individuals.

Methods and analysis: This will be a mixed-methods feasibility RCT. We will recruit 80 patients with chronic musculoskeletal pain with their informal caregivers. Patients will be randomised to usual National Health Service (NHS) care OR usual NHS care plus a caregiver-patient dyad training programme (JOINT SUPPORT). This programme comprises of five, 1-hour, group-based sessions for patients and caregivers, delivered by trained physiotherapists or occupational therapists. It includes developing skills in: understanding pain, pacing, graded activity, fear avoidance and goal-setting, understanding benefits of physical activity and skills in medication management. This will be re-enforced with a workbook. After the group-based sessions, patients and caregivers will be supported through three telephone sessions with a therapist. Data collected at baseline and 3 months will include: screening logs, intervention logs, fidelity checklists and clinical outcomes on quality of life, physical and emotional outcomes, adverse events and resource use. Qualitative research with 24 patient-caregiver dyads and 12 healthcare professionals will explore the acceptability of trial processes. Stop-go criteria will inform the progression to a full trial.

Ethics and dissemination: Ethical approval was obtained on 22 February 2022 (National Research Ethics Committee Number: 22/NW/0015). Results will be reported at conferences, peer-review publications and across social media channels.

Trial registration number: ISRCTN78169443.

Keywords: PAIN MANAGEMENT; REHABILITATION MEDICINE; RHEUMATOLOGY.

Publication types

Clinical Trial Protocol
Research Support, Non-U.S. Gov't

MeSH terms

Caregivers / psychology
Chronic Pain* / therapy
Cost-Benefit Analysis
Feasibility Studies
Humans
Multicenter Studies as Topic
Musculoskeletal Pain* / therapy
Pragmatic Clinical Trials as Topic
Quality of Life
Randomized Controlled Trials as Topic