Activity and life-role targeting rehabilitation for persistent pain: feasibility of an intervention in primary healthcare

Background: The activity and life-role targeting rehabilitation programme (ALAR) promotes patient’s active involvement in pain rehabilitation.Purpose: to explore the feasibility of ALAR applied in a primary healthcare context.Materials and methods: An intervention was conducted at primary healthcare centres. Patients experiencing persistent pain were randomly assigned to ALAR + MMR or Multimodal pain rehabilitation (MMR). Data were collected by patient questionnaires before and after intervention (9 weeks and 1 year), medical record examination and therapist telephone interviews.Results: Seventy percent of ALAR + MMR participants completed the programme (n = 24). Complete data were obtained for half of the participants (ALAR + MMR n = 15, MMR n = 17). More ALAR + MMR than MMR participants perceived that they had been participating in planning their rehabilitation. The addition of ALAR to MMR induced higher costs short term, but had favourable health-economic effects in the long term.Conclusions: The methods for delivering ALAR in primary healthcare by specially trained physio and occupational therapists were feasible. Therapists’ acceptability and perceived usability of the ALAR programme was high. More ALAR + MMR than MMR participants withdrew without completing treatment. Measures to increase patients’ acceptability of the ALAR programme are warranted. Flexibility in number of treatment sessions and addressing patients’ self-efficacy for undertaking rehabilitation is suggested, thus emphasising a more individualised rehabilitation plan.