Pain at Work Toolkit in Employees With Chronic Pain (PAW)

University of Nottingham

Status: Completed

Conditions: Chronic Pain; Pain, Chronic

Treatments: Behavioral: Pain at Work Toolkit; Other: Active control

Study type: Interventional

Funder types: Other

Identifiers

NCT05838677

Blake_PAWFeasibilityTrial_2023

OBF/FR-000023820 (Other Grant/Funding Number)

DERR1-10.2196/51474 (Registry Identifier)

Details and patient eligibility

About

This project will test the feasibility and acceptability of the Pain at Work (PAW) Toolkit which aims to help employees self-manage chronic or persistent pain at work. Ultimately, the investigators want to discover if it improves employees' health, wellbeing, confidence to self-manage their condition, and reduces impacts on their ability to work and be productive at work. Prior to testing the effectiveness and cost-effectiveness of the PAW Toolkit in a large-scale randomised trial, the investigators are conducting a multicentre pragmatic cluster randomised controlled feasibility trial. This will establish whether the PAW Toolkit, and our research processes, are feasible and acceptable in workplace settings, and will inform the design of a future trial. In this feasibility study, organisations will be randomised at site level to receive the intervention (PAW Toolkit plus occupational therapist (OT) support calls) or control (treatment as usual) for any individual employees who consent to take part. The investigators aim to recruit around 120 participants ("individual employees") from around 8 sites ("clusters"). Data will be collected from employees and organisations at baseline, 3 months and 6 months, using online surveys. At 6 months, up tp 40 people from across different sites and job roles will be interviewed, including employees who have accessed the PAW Toolkit, and other stakeholders (people who have been involved in supporting them at work, such as their line manager).

The data will be used assess whether the intervention and the research processes are acceptable and feasible, and the information collected will be used to plan a large-scale randomised controlled trial.

Full description

Background:

Chronic or persistent pain affects around 28 million adults in the United Kingdom (UK), reducing quality of life and people's ability to work or be productive at work. Sickness absence and reduced productivity costs the UK economy £73 billion per year.

Access to work advice and support for people living with pain is variable. Most people with chronic pain do not receive work advice through healthcare services, and employers do not routinely provide education or support for people with chronic pain. The Pain at Work (PAW) Toolkit aims to equip people who have pain with the knowledge, skills and confidence to: effectively self-manage a painful condition at work; access help and support; enjoy a better work experience; remain in the workforce.

Aims:

The aim of the trial is to determine the feasibility of conducting a definitive cluster randomised controlled trial (cRCT) of the effectiveness and cost-effectiveness of the PAW Toolkit for working-age adults with chronic or persistent pain. To achieve this, the objectives are:

• To measure feasibility outcomes to assess whether it would be possible to recruit to a definitive trial (recruitment, retention).
• To test the feasibility of reaching different employee groups (e.g., age, gender, ethnicity, job role or type), sectors (e.g., public, private, third) and organisation types (e.g., small-to-medium, or large enterprises).
• To explore whether participants and employers find the intervention and trial design acceptable.
• To obtain an estimate of the intra-cluster correlation coefficient to inform the future sample size calculation for the main trial.
• To collect a range of outcome measures to help identify the most appropriate primary outcome for a definitive trial.
• To collect data to assess the feasibility of capturing health economic data in a future trial.
• To design a future trial and implementation plan.

Protocol/ Method:

Trial configuration includes 3 work packages (WP's): feasibility trial (WP1); health economics evaluation (WP2); nested interview study (WP3).

Setting is community, comprised of employment settings in different sectors (public, private, third) in England, varying in size (small:10-49 workers; medium: 50-249 workers; large: >250 workers).

Sample size estimate: The aim is to recruit a minimum of 8 worksites ("clusters"), approximately 4 per arm. Up to 120 participants ("employees") will be recruited from these clusters over 12 months.

A nested interview study will be conducted, in which up to 40 people will be interviewed after 6 months. Participants in the interview study will include employees from the intervention arm, and stakeholders (identified by employees as having been involved in their support at work). Stakeholders may include line managers, company owners, human resources or occupational health specialists, or trade union representatives).

Organisations are randomised to either i) active control group (TAU: treatment as usual), or ii) TAU plus PAW Toolkit. Intervention participants can also opt in to receive up to 3 telephone calls with an occupational therapist. The content of the calls will include orientation to the PAW Toolkit and individually tailored advice on managing pain at work.

The following outcome measures will be collected (for detail, see Outcome Measures section):

A. Feasibility and acceptability outcomes:

B. Employer-reported outcome measures

C. Participant-reported outcome measures (PROMs)

Enrollment: 380 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (Organisations)

• organisations in England
• organisations with 10 or more employees.

Inclusion Criteria (Employee participants)

• working-age adults (employees)
• aged 18 and over
• self-reported chronic pain interfering with their ability to undertake or enjoy productive work
• able to comprehend English language
• able to provide informed consent.
• access to the internet to be able to access the web-based intervention and online surveys for data collection.

Exclusion Criteria (Organisations)

• organisations outside of England
• micro-organisations with fewer than 10 employees

Exclusion Criteria (Employee participants)

• unemployed at recruitment
• under 18 years of age
• no chronic pain at recruitment
• unable to comprehend English language
• unable to provide informed consent

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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380 participants in 2 patient groups

Intervention Group: Pain at Work Toolkit

Experimental group

Description:

Intervention participants receive the PAW toolkit plus 3 x optional occupational therapy calls (approximately 30 minutes each) involving orientation to the PAW Toolkit and individually tailored advice and behavioural strategies for managing pain at work. This digital web-based toolkit is designed to support people with chronic pain in self-managing their condition at work. PAW offers evidence-based advice about chronic or persistent pain, disability rights, work capacity, pain self-management strategies and signposting to support.

Treatment:

Behavioral: Pain at Work Toolkit

Active Control Group: Treatment as Usual

Active Comparator group

Description:

Participants do not receive the PAW Toolkit but instead have treatment as usual (TAU) from their employer. The nature of TAU will be recorded as part of the feasibility study. Depending on the employing organisation, TAU may consist of (but is not limited to) any combination of the following: occupational health, counselling, line manager support, signposting to education about factors that may have positive or negative effects on chronic pain. Participants can access non-specialist telephone calls from a researcher to discuss their participation in the study.

Treatment:

Other: Active control