QUantifying the Impact of Chronic pain on engagement in paid worK (QUICK)

Chronic pain is pain that persists over months or years and fails to respond to usual pain care. It has many causes but it is often musculoskeletal in nature (for example, back pain). Chronic pain affects the kind of work people do and how they engage in it, in a range of different ways - from impacting how much work one can do on a day-to-day basis, to long-term career choices. There is currently no standard questionnaire that can fully explore or measure the impact of chronic pain on people’s ability to work. Existing questionnaires assume people have one job and are contracted to work a certain number of hours every week. They do not ask about the different ways pain might affect work and they are not designed for modern ways of working, such as holding several part-time jobs or having "zero hours" contracts.

​​​​​​We aim to develop a questionnaire that can be used to assess the many different ways in which chronic pain affects work ability, taking into account modern ways of working. By doing this we aim to create a standardised instrument that can be used in future studies to assess and compare the impacts of chronic pain on working life in a variety of contexts.

In order to develop the questionnaire, we are currently in the process of carrying out several distinct phases of research work:

Literature review

This phase is now complete. We have conducted a review of the scientific literature to identify any existing questionnaires which ask about impacts of chronic pain on work, and have compared these with findings from interview studies where people discussed the wider range of impacts they have faced when dealing with chronic pain at work.

Focus groups with patients and key stakeholders

The second phase of the study is also now complete, and involved a series of focus groups with people with chronic pain, employers, healthcare professionals, researchers and policy makers to further explore the ways in which chronic pain impacts individuals’ ability to engage with work.

Using this information, in combination with the results from our literature review, we then developed an initial draft of a new questionnaire based on the findings of these focus groups.

Delphi study

This stage is now complete. Following on from the above phases, we further refined the wording and content of our initial draft questionnaire using what is known as a 'Delphi' process. This process included several rounds of further feedback and voting from patient partners, a range of employers, representatives of all the different relevant expert groups and policy-makers to make sure it is easy to understand and covers all the relevant areas.

Evaluation survey

The final phase of the QUICK study is now underway. Within this we are assessing the validity and usability of the new instrument by asking people with chronic pain to complete the new questionnaire via an online survey. We are also seeking perspectives on how easy it is to understand the questions, whether any important work-issues were missed out, and for any other feedback, and have collected face-to-face feedback from some participants.  ​​​​​Data collection for this phase is now complete, and analysis is currently underway.

We have now completed the first three phases of the QUICK study, and are now in our final evaluation phase, where we are testing our draft questionnaire.

Publications

The first paper from this study has now been published, and discusses the review phase where we looked at existing questionnaire items and work impacts:

• Stagg, AL, Madan, I, Fear, N, Stevens, MJ, Wainwright, E, Hoving, JL, Macfarlane, GJ, Hollick, RJ and Morton, L, Do current methods of measuring the impact of chronic pain on work reflect the experience of working-age adults? An integrated mixed-methods systematic narrative review, (2024) PAIN ():10.1097/j.pain.0000000000003169, February 20, 2024. | DOI: 10.1097/j.pain.0000000000003169

We have also produced the following poster which details the study progress to date. This poster was presented at the International Congress on Occupational Health (ICOH) 2024 in Marrakesh, Morocco on 30th April 2024:

• LaKrista Morton, Martin J Stevens, Elaine Wainwright, R Stuart Anderson, Ira Madan, Nicola Fear, Suzanne Verstappen, Paul McNamee, Anne Stagg, Nicola Goodson, Karen Walker-Bone, Rosemary J Hollick, Gary J Macfarlane, QUantifying the Impact of Chronic pain on worK (QUICK), 34th International Congress on Occupational Health, Marrakesh, Morocco, 30th April 2024
  
  

Summary report to funders

During a recent visit to the Epidemiology Group premises at Foresterhill Campus, we were delighted to present our latest research findings to one of our key funding partners, Versus Arthritis. As part of these presentations, we produced a poster summarising the work we have done so far on the QUICK study.

You can view and download the poster below:

• Stevens, Morton, Wainwright, Anderson, Madan, Fear, Verstappen, McNamee, Stagg, Goodson, Walker-Bone, Hollick and Macfarlane, A new questionnaire tool to capture the impact of chronic pain on work
  
  

Podcasts

QUICK Research Fellow Dr Martin Stevens was invited as a guest on the Joel vs Arthritis 'Chronic Pain Club' podcast, where he discussed patient and public involvement in some studies he has been involved in, including QUICK.

You can watch a full video of Martin and Joel's discussion below:

Videos

If you are interested in finding out more about the QUICK project, you can watch the following short video in which Dr Martin Stevens discusses the work we have done so far, reveals some of the study's key findings, and provides more detail about how our draft questionnaire has been developed: 

​​​​The goal of this project is to create a  new questionnaire which has been agreed by patients and other important stakeholder groups which can successfully measure the ways that chronic pain impacts on work in all types of settings. This questionnaire can then be used to assess and quantify the impact of positive health interventions on working, for example, to show whether pain treatments are good at helping people with pain cope better at work, or whether changes made in workplaces have improved work ability for people with chronic pain.

Chief investigator

• Professor Gary Macfarlane

Co-investigators

• Dr Karen Walker-Bone (University of Southampton)
• Dr Ira Madan (King’s College London)
• Professor Nicola Fear (King’s College London)
• Dr Nicola Goodson (Aintree University Hospitals)
• Dr Suzanne Verstappen (University of Manchester)
• Dr Paul McNamee
• Dr Rosemary Hollick

Research co-investigator

• Dr LaKrista Morton

Research team

• Dr Martin Stevens - Research Fellow
• Dr Anne Stagg - Research Associate (King's College London)
• Mr Stuart Anderson - Project Coordinator

This study is funded by the Medical Research Council.

Work terms

Absenteeism - Being absent from work, e.g. sickness absence

Presenteeism - Being less productive at work, e.g. requiring more time to complete a given task than was previously/usually needed

Gig economy - Jobs where an individual receives payment for the tasks they complete (e.g. a food delivery) rather than a set wage or salary

Study / methodological terms

Systematic review - A systematic review is a methodology where the literature relevant to a given research question is identified within in a series of pre-specified processes. Relevant data/information from the identified literature is then brought together to provide a synthesis of what we know about a given subject.

Delphi technique - The Delphi technique is a methodology that facilitates communication from a range of experts stakeholders on a given subject matter and ultimately aims to reach consensus from stakeholders on the topic. Input from expert stakeholders is collated, synthesised, and put back to the stakeholder group for further feedback in subsequent rounds until consensus is reached.

Focus groups - Focus groups are a qualitative methodology in which selected individuals provide their perspectives on a given area of discussion, which is moderated by the researcher(s). Within focus groups, data is gathered from the interaction of research participants and therefore differs from the data gathered from one-on-one qualitative data collection methods (e.g. interviews).

Interviews - Interviews are a qualitative methodology in which questions are asked of the research participants by the interviewer/researcher. The questions asked of each participant may evolve within and between interviews, depending on the specific interview methodology utilised.

Email: QUICK@abdn.ac.uk