Developing an activity pacing framework for chronic pain/fatigue
Research type
Research Study
Full title
Developing an activity pacing framework for the management of chronic pain/fatigue
IRAS ID
213301
Contact name
Deborah Antcliff
Contact email
Sponsor organisation
Pennine Acute Hospitals NHS Trust
Duration of Study in the UK
0 years, 11 months, 2 days
Research summary
Activity pacing is frequently advised in the management of chronic pain/fatigue, including chronic low back pain, chronic widespread pain/fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis, (CFS/ME). However, there is no agreed definition of ‘activity pacing’ and it is instructed in various ways by different healthcare professionals. For some, pacing involves adapting/limiting activities (for example, breaking down tasks/using rest breaks); whilst for others, pacing involves having consistent activity levels/gradually increasing activities. Furthermore, previous research has found pacing to be associated with both improved symptoms (decreased fatigue, anxiety and depression) and worsened symptoms (increased pain and disability).
Due to the frequent referral of patients with chronic pain/fatigue (20% of those frequently attending healthcare appointments/investigations), together with the cost of chronic pain/fatigue on patients’ quality of life and financial burden on the NHS/society (>£12,000 million per year for back pain alone), it is imperative that coping strategies such as pacing are clearly defined and based on evidence.
This study involves the first two stages in the development of an activity pacing framework to standardise how pacing is instructed by healthcare professionals. Stage I involves an online survey of current pacing interventions across healthcare professionals working in UK-wide NHS services (doctors/nurses/physiotherapists/occupational therapists/clinical psychologists). The survey findings, together with existing research evidence will help to develop the initial pacing framework. Stage I is expected to be completed within seven months.
Stage II will further develop the framework using a nominal group technique with a consensus meeting involving 4-5 patients and 5-7 healthcare professionals. Stage II will be completed within four months. Further study will test the framework in the clinical setting. The pacing framework has the potential to improve treatments by providing guidance on the specific components of pacing found to have benefits for patients.
This study is funded by a HEE/NIHR ICA Clinical Lectureship.
REC name
West of Scotland REC 5
REC reference
16/WS/0209
Date of REC Opinion
7 Oct 2016
REC opinion
Favourable Opinion