Table 2 Intervention content
Time | Objectives | Method | Short term patient outcomes |
|---|---|---|---|
Pre-consultation: patient letter | • To manage patients’ expectations & ease their communication with clinicians during the consultation through preparation | • Providing information on who is the consultation team, who they might get to see, and why • Making clear that surgery is not necessarily indicated • Requesting patients to bring a list of previous treatments & questions | • Realistic expectations • Reduced anxiety • Greater buy-in to alternative to surgery • Reduced disappointment when surgery is not offered |
During- consultation: short educational online video | • To improve the delivery of clear and concise information • To increase HCP confidence in delivering the message that surgery is not recommended, by providing information on other options tailored to individuals • To increase clinicians’ skills in delivering effective reassurance, including validation of patients’ pain experience | • Education about appropriate use of terminology • Information about eliciting and responding to psychological issues • Education describing timely and effective validation • Advice on provision of other interventions and options that might help people manage their pain | • Increased perceived reassurance • Reduced anxiety and intention to further seek care • Compliance and buy-in to self-management • Knowledge about alternative options |
Post-consultation: patient letter | • To increase patients’ understanding & accurate recall of what was discussed in the consultation • To increase options and support for pain management by providing resources | • Personalised summary of the impact of pain on patients’ life • Summary, in lay terms, of the investigation results • Summary of previous interventions and management attempts • Summary of discussion, recap of patients’ goals • Re-cap of options for self-management and other support to living with pain | • Comprehension and acceptance of consultation decisions • Satisfaction with information provided • Reduced intensions to re-consult |