Collaboratory Treatment Pathway for Chronic Pain Patients.

Summary

In this multicenter randomized controlled trial, the aim is to evaluate the effectiveness of a standardized treatment pathway (STP) for patients referred to four participating pain clinics, by comparing it to treatment as usual (TAU) which is standard care at the clinics.

The STP differs from TAU in two key aspects:

* Structured cross-sector collaboration: Involvement of primary healthcare providers, particularly the patient's GP, in two digital collaborative meetings with the pain clinic.
* Time-bound treatment pathway: A clearly defined treatment trajectory with follow-up over a six-month period.

The study aims to answer whether the STP give larger improvements than TAU in the following outcomes:

* patients´ reported overall impression of change in health (primary outcome)
* pain interference (primary outcome)
* physical function and mental health
* satisfaction with and experience of continuity and integration of the health care services

All study participants will follow an initial care pathway at the pain clinic, which includes:

* a screening consultation with a study coordinator
* a multidisciplinary clinical assessment based on a biopsychosocial approach by at least to health care professions. The specific professional groups included in each assessment are determined individually based on patient needs.

The control group:

This group will receive standard care at the pain clinic. This will vary somewhat between the four pain clinics , but almost all patients will be offered a summary consultation with the pain clinic team where further plans for follow-up will be discussed. Some patients will be offered further treatment at the pain clinic.

All clinics will send a clinical summary to the referring physician with suggestions for further follow-up. If further collaboration with primary care is needed, it may preferably be written or arranged via telephone. Digital collaborative meeting will not be offered to this group.

The intervention group:

All patients in this group will be offered the STP with two digital collaborative meetings as described above.

Conditions

• Chronic Pain
• Chronic Pain Syndrome
• Chronic (Non-malignant) Musculoskeletal Pain
• Patients Referred to Multidisciplinary Pain Clinics

Interventions

OTHER

A collaborative treatment pathway for patients referred to multidisciplinary pain clinics in Norway

The study intervention is a standardized treatment pathway for patients referred to multidisciplinary pain clinics. The pathway is designed to support structured collaboration across health care levels and other sectors. It includes two digital multidisciplinary meetings with the patient, the pain clinic, and additional stakeholders, such as social security representatives. The pathway delineates a clearly defined course of treatment with scheduled follow-up over a six-month period.

OTHER

Treatment as usual

The comparator intervention reflects the current standard of care provided at four Norwegian pain clinics. Standard care may vary slightly between clinics but generally includes a multidisciplinary clinical evaluation involving at least two different healthcare professions. A clinical summary outlining recommendations for further follow-up is sent to the referring physician. Most patients also receive a summary consultation with the pain clinic team, and some are offered additional treatment at the pain clinic.

Sponsors & Collaborators

• Haukeland University Hospital

  collaborator OTHER

• University Hospital of North Norway

  collaborator OTHER

• Sykehuset Innlandet HF

  collaborator OTHER

• St. Olavs Hospital

  lead OTHER

Principal Investigators

• Astrid Woodhouse, Phd · St Olavs Hospital/ Smertesenteret

• Mari Glette, PhD · St. Olavs Hospital

• Tormod Landmark, PhD · St. Olavs Hospital

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-12-19

Primary Completion

2028-12-31

Completion

2028-12-31

Countries

• Norway

Study Locations