Abordaje multidisciplinar y grupal de adultos con dolor crónico no oncológico en un centro de atención primaria

Abstract

Chronic non-oncological pain (CNOP) is a common cause of primary care consultation. It affects physical and mental health, and is frequently associated with disability. The usual treatments are pharmacological, while education and exercise strategies recommended by clinical guidelines are rarely used.

Objective

To evaluate a group intervention based on education, psychological intervention and physical exercise to manage CNOP and/or fibromyalgia.

Materials and methods

Pilot study, without control group, conducted in Primary Care. We evaluated three groups, with a total of 42 adults with CNOP and/or fibromyalgia. Intervention: neuroscience education (1 session), psycho-educative groups (5 sessions) and physical exercise (5 sessions). We measured the change in perceived pain with the visual analogue scale (VAS), quality of life with the SF-36 version 2 questionnaire and number of chronic analgesics used, and we analyzed the data with the paired sample Student's t test (statistical significance: p < 0.05).

Results

Perceived pain decreased on average by 0.59 (SD: 1.59) (p = 0.057), the number of analgesics used by 0.32 (SD: 0.72) (p = 0.008) and the SF-36 score increased 3.83 (SD: 8.89) (p = 0.031). The dimensions of the SF-36 questionnaire that improved were bodily pain, with a mean variation of 7.25 (SD: 13.90) (p = 0.01), social function 7.58 (SD: 16.43) (p = 0.021), mental health 9.46 (16.57) (p = 0.005) and vitality 7.59 (SD: 18.66) (p = 0.041).

Conclusions

A group intervention with active strategies based on neurosciences education, psychological intervention, and physical exercise was useful to reduce pain and chronical use of analgesics and improve the quality of life of patients with CNOP.