Pain change during the european program EFFICHRONIC among vulnerable patients with a chronic condition ; Evolution de la douleur au cours du programme européen d'éducation à la santé EFFICHRONIC, chez des patients vulnérables, et atteints de maladie chronique

Chronic pain affects a large part of the population, with considerable consequences onthe quality of life, inducing physical and psycho-social vulnerabilities. It causes direct coststhrough treatments, and indirect costs through reduced productivity of the patients.Reciprocally, pain is impacted by psychological and socioeconomic factors. Chronic conditionscan be improved by reducing modifiable risk factors. Several education programs, such as theChronic Disease Self-Management Program (CDSMP), have shown benefits of patientempowerment and health literacy. However, in vulnerable populations, the impact of suchprograms has received little attention, although prevalence of chronic conditions issignificantly higher. The present research is the first multicentric evaluation of the ability ofthe CDSMP to improve pain. It is based on the project EFFICHRONIC, involving socioeconomicallyvulnerable participants, with a chronic condition, in five European countries.Adjusting for a wide range of variables, and using multiple imputation methods for morethan a thousand participants, we found that pain was significantly lowered after theintervention (in both complete cases and imputed datasets). Although the effect size wasweak, our results support the idea that such training programs are able to improve pain andalleviate its consequences on quality of life, particularly in vulnerable populations. Thebenefits of the intervention appeared to be greater for younger participants, and those witha higher education level. Such specificities of our target population reinforce the idea thatthe recognition of the social determinants of health is essential. ; La douleur chronique touche une grande partie de la population, avec des conséquencesconsidérables sur la qualité de vie, induisant des vulnérabilités physiques et psychosociales.Elle entraîne des coûts directs via les traitements, et des indirects via une productivitéréduite des patients. Réciproquement, la douleur est impactée par des facteurspsychologiques et socio-économiques. ...