Pain Science Education for People With Persistent Pain on NHS Waiting Lists: A Mixed Methods Study.

Background: Persistent pain is a leading cause of disability worldwide. Long waiting times can adversely affect outcomes and impede effective management; thus, waiting list-targeted interventions may be beneficial. Objective: To explore the perceptions of people with persistent pain receiving pain science education (PSE) online, en masse, whilst on an NHS waiting list. Methods: A mixed-methods observational study of people with persistent pain on NHS waiting lists was undertaken. PSE-informed webinars were delivered by Flippin' Pain, a U.K.-based public health campaign. A questionnaire was circulated postwebinar exploring participants' experience of the webinars collectively and future behavioural intentions. Quantitative data were analysed using descriptive statistics. Reflexive thematic analysis was used to analyse qualitative data. Results: Participants' (n = 114) pain originated primarily from musculoskeletal sources. Postwebinar, participants felt more hopeful about their future (64%), intended to increase activity levels (71%), intended to reduce their opioid use (51%) and felt that they may be more confident to talk to others about their pain (42%). Overall the webinars were well received; they were considered interesting, and participants reported that they provided feelings of hope and empowerment. 80% of participants would recommend the webinars to others, although a small minority of participants were strongly negative about the webinars and found them unhelpful. Conclusion: Participants on NHS waiting lists with persistent pain predominantly found PSE webinars helpful. It shifted their understanding of pain, and they intended to undertake self-management activities in line with evidence-based care. Appropriately powered RCTs are warranted to robustly investigate the effectiveness of en masse PSE for patients awaiting care.