Helping people live with chronic pain

Audio: Managing chronic pain

Join Professor James Elander as he discusses his work on chronic pain and how his and his colleagues’ research has helped refine NHS standards.

Managing chronic pain transcript

The Purpose

Many patients with chronic illnesses suffer pain that is secondary to the main symptoms of their condition. While it causes significant distress, this pain is often regarded as lower priority by healthcare providers and can sometimes be overlooked in treatment protocols.

Researchers at the University of Derby have raised greater awareness of the problem, leading to changes in care practices internationally that ensure sufferers can live with their pain more effectively. The work has shaped pain management programmes in both the UK and USA, especially for:

• Treating the severe joint pain endured by people with haemophilia
• Administering pain-relieving drugs to patients with sickle cell disease (SCD)

Haemophilia

Research findings

Since 2006, Professor of Health Psychology James Elander has led interdisciplinary studies investigating how people with haemophilia cope with the agony of recurrent joint bleeds. This has included producing the first evidence about pain acceptance among people with haemophilia, plus a DVD to help affected people self-manage their pain.

Having generated wider recognition of haemophilia as a chronic pain condition, the research brought about improvements in practice promoted by influential US bodies such as the National Hemophilia Foundation and the Medical and Scientific Advisory Council Pain Initiative. In Europe, coverage of the research in top-ranked journals led to numerous requests for the pain management DVD.

Sickle Cell Disease (SCD)

Research findings

Another key strand of the University’s research focuses on the pain associated with SCD, a condition affecting the red blood cells. It has addressed a trend where some SCD patients have been stigmatised as ‘drug-seeking’, with healthcare staff reluctant to prescribe strong analgesics for pain relief because of their concerns over the opioid epidemic.

Providing comparisons between the UK and USA, the research has explored SCD patients’ experiences of how their painful episodes were managed in hospital and how their pain was perceived and assessed by care staff. A major psychometric exercise resulted in the development of new ways to measure patients’ satisfaction with their pain treatment.

The findings have since been used to underpin clinical practice, staff training and evaluation of pain management in organisations with registered SCD patients, from the Barts Health NHS Trust in London to the Johns Hopkins University School of Medicine in Baltimore.

In addition, they have informed:

• NHS standards for the management of adults with SCD
• US government guidelines on treating SCD patients in Medicare
• A handbook on methadone prescribing
• Materials for the Sickle Cell Open Education Resources project

In the US, the research was also the basis for guidance issued by the Department of Health and Human Services on differentiating addiction from pseudo-addiction and managing chronic pain in the context of substance use disorders.

Continuing our research

Further research has seen the University of Derby collaborating with NHS Multidisciplinary Pain Services to explore the factors that affect the success of treatment for chronic back pain. This has supported the planning and long-term effectiveness of pain management programmes.

Funders

• REMEDI and London Guildhall University
• The Haemophilia Society UK and the Institute of Health Policy and Research, London Metropolitan University
• Barts and the London Charity Strategic Research Fund

Researchers

• Professor James Elander, Professor of Health Psychology (2007-present)
• Professor David Sheffield, Director of Professional Psychology Programmes, University of Derby Online Learning (2009-present)
• Andrew Baird, Senior Lecturer in Ergonomics and Psychology (2006-present)

Discover more

Research papers:

• Development and validation of the Satisfaction with Treatment for Pain Questionnaire (STPQ) among patients with sickle cell disease
• Randomized trial of a DVD intervention to improve readiness to self-manage joint pain
• An assessment of the relative influence of pain coping, negative thoughts about pain, and pain acceptance on health-related quality of life among people with hemophilia

Blog

• Helping people with chronic pain to reduce their reliance on painkillers