1. electronic Persistent Pain Outcomes Collaboration update 2015
Chris Hayes
Hunter Integrated Pain Service
NSW Agency for Clinical Innovation
Faculty of Pain Medicine

2. ePPOC implementation so far ….
Data submitting services:
21 adult:
New South Wales (14)
Victoria (6)
Western Australia (1)
3 paediatric (New South Wales)

3. ePPOC implementation so far ….
In progress:
14 adult:
New South Wales (2)
Victoria (9)
Western Australia (1)
Queensland (1)
New Zealand (2)
3 paediatric
Victoria (2)
41 services in total have ‘signed up’

4. National data – overview (adult data)
Questionnaires
All services
Number of patients
6361
Number of questionnaires returned
6267
- Referral (baseline)
5159
- Pathway (treatment) start
410
- Pathway (treatment) end
170
- Post-episode follow-up 50
updated data since the abstract

5. National data – overview (paediatric)
Questionnaires
All services
Number of patients
113
Number of questionnaires returned
104 (P) 100 (C)
- Referral (baseline)
78 (P) 78 (C)
- Pathway start
10 (P) 10 (C)
- Pathway end
1 (P) 1(C)
- Post-episode follow-up

6. Top 5 main pain sites

7. Number of pain sites

8. Pain duration

9. Medication use Patients using opioid medication >2 days per week
55.8%
Average daily oral morphine equivalent
62.7 mg
(max =1560 )
Average number of major drug groups (of six)
2.9

10. National clinical profile
Measure
Referral (n=5159)
Interpretation
BPI pain severity
6.4
Moderate (7= severe)
BPI interference
7.1
DASS depression
20.3
Moderate (21=severe)
DASS anxiety
14.2
Moderate (15=severe)
DASS stress
21.0
Moderate
Pain catastrophising
30.0
High (≥30 = high)
Pain self efficacy
20.6
Moderate (<20 = severe)

11. NSW clinical profiles Measure Tier 2 Tier 3 Other BPI pain severity
(i.e. not NSW)
BPI pain severity
6.3
6.4
BPI interference
7.0
7.1
DASS depression
20.2
20.4
DASS anxiety
13.8
14.4
14.5
DASS stress
21.0
20.7
Pain catastrophising
29.1
30.6
30.3
Pain self-efficacy
21.2
20.3

12. Treatment pathway outcomes (n=126, 104 PMPs)
Measure
Pathway start
Pathway end
BPI average pain
6.2
5.6
BPI interference
7.0
5.7
DASS depression
19.2
15.3
DASS anxiety
13.5
11.7
DASS stress
20.2
18.3
Pain catastrophising
26.9
19.8
Pain self-efficacy
20.6
27.7

13. BPI average pain IMMPACT recommendations for assessing change -
5.1% made substantial change
13.7% moderate change
29.9% minimally important change
31.6% did not change, 19.7% deteriorated

14. DASS depression 40.2% made clinically significant change
46.2% did not change
13.7% deteriorated
(Based on ≥5 pt change and move to different severity category)

15. Literacy and CALD (ePPOC)

16. Complexity (ePPOC)

17. Pathway type (ePPOC) Pathway HIPS All Services Number Percentage Group
466
81.9
866
35.8
Individual 64
11.2
1142
47.2
Concurrent 39
6.9
242
10.0
One-off
0.0
172
7.1
All pathways
569
100.0
2422

18. Wait time (ePPOC)

19. Average outcome scores (ePPOC)

20. Medication use (ePPOC)

21. 2015 ….
Continue implementation of ePPOC throughout Australia and New Zealand
Investigate/identify sub-groups of patients getting better, worse, not improving
Maximise follow-up data
Start benchmarking process