Macquarie University Research
The Northern Sydney PHN, operated by the Sydney North Health Network (SNHN), is one of 31 Primary Health Networks (PHNs) established by the Australian Government to increase the efficiency and effectiveness of medical services for the community. The network’s focus is on patients who are at risk of poor health outcomes, and they work to improve the coordination of care, so they receive the right care, in the right place at the right time.
Recently, the SNHN invited qualified and experienced allied health professionals working in primary care in Northern Sydney, to provide innovative and creative approaches to delivering allied health services through a ‘Request for Proposal’ process. The allied heath grants were intended to recognise innovation and contributions of allied health professionals in response to emergencies and natural disasters, or in enhancing primary health services that promote community connection across the region.
After being made aware of this request for proposal by the ACA and recognising the need for greater integration with the SNHN, I applied and successfully obtained funding for the development and conduction of a Community Chronic Pain Program. This program provides pain education, counselling, and exercise therapy for individuals with persistent and disabling chronic pain. The program is based off principals of shared medical appointments, which are ‘a series of individual office visits sequentially attending to each patient’s unique medical needs individually, but in a supportive group setting where all can listen, interact and learn’.1 Furthermore, there is evidence to suggest that small group educational sessions for individuals with chronic pain and low to moderate distress, are an effective tool for the management of persistent pain.2
The goals of the program are to:
- improve functional capacity through education and exercise;
- assist participants to identify goals, barriers, and boundaries to pain management; and
- develop crisis management strategies and self-help routines.
Each program consists of:
- a 1.5-hour face-to-face education and exercise session once a week that will run over five consecutive weeks;
- small group size – max 10 participants.
Participants are provided with the following:
- a workbook which includes goal charts, exercise charts, suitable exercises and a list of resources including websites for further information relating to self-management of chronic pain;
- relaxation techniques and assistance with setting up self-help routines at home.
On completion of the program, participants are re-evaluated via self-reported outcome measures and feedback on the program is obtained. Participants are contacted at three months and six months post program to obtain long term outcomes. Referring GP and allied health professionals receive a report following the program that details the patient’s progress through the program to assist with follow-up and continued cycle of care.
This Community Chronic Pain Program is an example of an innovative initiative to improve the access to multi-disciplinary health services within primary care for individuals with chronic pain. The support from the SNHN highlights how integration with medical services, government networks and chiropractic clinics, is not only possible but encouraged. I look forward to further developing the program and providing these services to the local community.
David McNaughton PhD
References:
- Egger, G., et al., Shared medical appointments An adjunct for chronic disease management in Australia? Australian Family Physician, 2014. 43: p. 151-154.
- Joypaul, S., et al., Multi-disciplinary interventions for chronic pain involving education: A systematic review. PloS one, 2019. 14(10): p. e0223306.