Valérie Piguet*, Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, University Hospitals of Geneva, Geneva, Switzerland Gaelle Molinari, Department of Psychology, Distance Learning University,, Geneva, Switzerland Christophe Luthy, General Medical Rehabilitation, University Hospitals of Geneva, Geneva, Switzerland Sarah Kupferschmid, Nursing Directorate, University Hospitals of Geneva, Geneva, Switzerland Maria Caiata-zufferey, Institute of Communication and Health, University of Lugano, Lugano, Switzerland Anne-francoise Allaz, General Medical Rehabilitation, University Hospitals of Geneva, Geneva, Switzerland Christine Cedraschi, Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, University Hospitals of Geneva, Geneva, Switzerland Track: Practice Presentation Topic: Consumer empowerment, patient-physician relationship, and sociotechnical issues Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-12

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Despite advances in multidisciplinary chronic pain management in which prescription of analgesics is a cornerstone, a significant percentage of chronic pain patients (CPPs) are not relieved. Analgesics are largely contributing to this poor outcome with half of CPPs reporting medication misuse (underuse rather than overuse). The fear of somatic or psychic adverse effects, of tolerance and addiction are the most often cited reasons for reducing or stopping medication. Besides the pharmacological aspects, patients’ perceived difficulties and experiences with long-lasting analgesic treatments are thus important aspects to take into account in patient education.
The use of new information and communication technologies to promote participatory medicine by facilitating access to understandable, reliable and customized information is rapidly developing in patient education.
Aiming to increase CPPs’ skills to manage chronic pain and analgesics, we are currently developing an interactive pedagogical course intended to facilitate access to information on analgesics, exchanges on experiences with analgesics between CPPs and healthcare professionals and to enhance their safe use. This hybrid course, combining an Internet platform with usual face-to-face group meetings is based on socio-constructivist learning theories that promote an active and collaborative approach of learning as well as a user-centric approach that enhances personalized learning.
After a face-to-face module entitled “Welcome”, patients with musculoskeletal chronic pain referred to the Geneva Pain Centre (median age: 46 years, mainly qualified workers) will continue the course at home through 7 modules. These modules include activities concerning the advantages and pitfalls of analgesics information found on leaflets and Internet, mechanism of action of analgesics, their dosage, their adverse effects and their drug interaction. The complex information about pharmacological aspects of analgesics is transmitted by audiovisual presentations, illustrations with voice-over simple messages and quizzes. The exchanges of experiences are facilitated through activities such as brainstorming and discussion on the forum. Each learning module is designed to be relatively short to avoid early dropout due to concentration and/or increasing pain problems. The platform allows each patient to select an individual learning program guided by quizzes that defined users’ profiles and/or by other CPPs’ suggestions. Face-to-face modules called “Together” are scheduled regularly to discuss relevant issues emerging on the forum.
The first aim of this course is to teach how to find relevant information to one’s own situation, why analgesics efficacy is variable or how to take extra analgesic doses to cope with breakthrough pain for example. The second part of the course is the elaboration of collaborative information including CPPs’ experiences - for example what to do in case of an adverse effect - using synchronous and asynchronous group activities. The aims of this course are to improve CPPs’ self-confidence for the long-term use of analgesics through better knowledge and social support from other patients and healthcare professionals. The course will be further evaluated in terms of its impact on analgesic use, pain improvement and daily activities.