A Cognitive Behavioural Therapy Pain Management Programme for Neuropathic Pain Post Spinal Cord Injury: A Feasibility Study Including the Clinician and Patient Perspectives

Objective: To evaluate the feasibility of a cognitive behavioural therapy pain management programme for managing neuropathic pain post-spinal cord injury.Design: A mixed methods prospective feasibility trial. Setting: A national rehabilitation hospital. Subjects: Adults with neuropathic pain post-spinal cord injury.Methods: Following ethical approval, participants were recruited from a spinal cord injury outpatient service.A multi-disciplinary team delivered the programme twice a week over five weeks.Changes in study outcome measures addressing quality of life, mood and sleep indices over three time periods were analysed using Friedman's test.Differences from baseline to intervention completion and six months follow-up intervals were analysed using Wilcoxon sign-rank test.Significance was set p<0.05.Post-intervention qualitative feedback was obtained from programme participants and the clinicians involved.Results: Eight participants completed the programme.Significant improvements were noted post-intervention in the psychological domain of the World Health Organisation Quality of Life Bref (Z=-2.120;p=0.03) and the depression score (Z=-2.555;p=0.01) of the Hospital Anxiety and Depression Scale, remaining significantly improved at six months follow-up when compared to baseline (Z=-2.533;p=0.01).Transportation was the main barrier to recruitment.Qualitative feedback highlighted the positive impact for participants in coping with pain.Clinicians noted many positive outcomes of the programme, whilst highlighting health-systems difficulties in implementation.Conclusions: A cognitive behavioural therapy pain management programme is perceived as beneficial by individuals with neuropathic pain after spinal cord injury, a finding supported by quantitative data analysis.Recruitment barriers to programme delivery indicate that alternate modes of delivery warrant consideration.