Occupational therapy lifestyle intervention added to multidisciplinary treatment for adults living with chronic pain: A feasibility study

OBJECTIVES: To evaluate the feasibility and outcomes of an occupational therapy lifestyle intervention for adults living with chronic pain. DESIGN: This one-group pre-post interventional study investigated the feasibility and outcomes of the Redesign Your Everyday Activities and Lifestyle with Occupational Therapy (REVEAL(OT)) intervention targeting meaningful activities and lifestyle. SETTINGS: The occupational therapist-led intervention was added to standard multidisciplinary chronic pain treatment at a Danish pain centre. PARTICIPANTS: Of the 40 adult participants aged 18-64 (mean 46.6±10.9 years old, 85% females, chronic pain duration ≥3 months), there were 31 completers. INTERVENTION: Three feasibility rounds were carried out in 2019-2021. The intervention focused on meaningful activities, healthy eating habits and daily physical activity. Methods of didactical presentations, group discussions, personal reflection and experiential learning were used in the intervention composed both of individual and group sessions. OUTCOMES: Primary outcomes were predefined research progression criteria evaluated by the red-amber-green method. Secondary outcomes measured pre-post changes in health-related quality of life and occupational performance and satisfaction. RESULTS: The study demonstrated satisfactory programme adherence (77.5%), patients' self-perceived relevance (97%), timing and mode of delivery (97%) and assessment procedure acceptance (95%). No adverse events causing discontinuation occurred. Recruitment rate (n=5.7 monthly), retention (77.5%) and the fidelity of delivery (83.3%) needed improvement. We observed no improvement in health-related quality of life (mean=0.04, 95% CI -0.03 to 0.12) but positive change in occupational performance (mean=1.80, 95% CI 1.25 to 2.35) and satisfaction (mean=1.95, 95% CI 1.06 to 2.84). The participants reached the minimal clinically important difference for occupational performance (≥3.0 points in 13.8%) and satisfaction (≥3.2 points in 24.0%). CONCLUSIONS: The REVEAL(OT) intervention was feasible to deliver and beneficial for the participants' occupational performance and satisfaction. The interventions' recruitment, retention and delivery strategies need optimisation in a future definitive trial. TRIAL REGISTRATION NUMBER: NCT03903900.