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Real world evidence

ESCAPE-pain stands for Enabling Self-management and Coping with Arthritic Pain using Exercise.

ESCAPE-pain offers two programmes:

  • ESCAPE-pain for knees and hips: designed to benefit people with chronic knee and hip pain, otherwise known as osteoarthritis.
  • ESCAPE-pain for backs: designed to benefit people with chronic low back pain.

ESCAPE-pain for backs

ESCAPE-pain for backs implements the NICE clinical guidelines for the management of low back pain [NG59]. The programme builds upon the strong evidence base behind the original ESCAPE-pain programme for knees and hips, following the same model and structure to help participants self-manage non-specific low back pain. ESCAPE-pain for backs was piloted in 2019 to assess whether the model and principles behind the original programme are effective in the self-management of non-specific low back pain.

The evaluation of the 2019 pilot showed that ESCAPE-pain for backs delivers effective care, managed in line with NICE guidelines, and significantly improves participant outcomes. All six pilot sites saw mean improvements in participant clinical outcome measures and found ESCAPE-pain for backs beneficial for participants in the self-management of non-specific LBP.

Since the 2019 pilot, (286 participants), the programme has been rolled out further to clinical and leisure sites across the country. See the graph demonstrating the clinical effectiveness of ESCAPE-pain for backs as it is spread into practice.

ESCAPE-pain for knees and hips

Robust evaluation shows that the ESCAPE-pain programme for knees and hips:

  • Reduces pain.
  • Improves physical function.
  • Improves the psychosocial consequences of pain.
  • Reduces healthcare and utilisation costs.

Participant outcomes from the ESCAPE-pain programme for knees & hips

ESCAPE-pain has a commitment to building a robust evidence base for our programme. Since spreading into practice, we have worked with delivery staff to ensure a database of clinical outcomes has been kept and updated on a regular basis. The sample size of our database has reached over 23,000 participants to date and continues to grow.

The graphs below relay the pre intervention and post intervention outcome scores for the Knee OA Outcome Score (KOOS), Hip OA Outcome Score (HOOS), and the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS) demonstrating ESCAPE-pain’s clinical effectiveness in practice, with a strong resemblance to what was found during the clinical trial (Hurley et al., 2007).

*SWEMWBS were removed from regular collection in 2020, in response to sites wanting to reduce the number of measures collected due to capacity restraints.

Comparing clinical outcomes in leisure/community and clinical settings

This graph below displays clinical outcomes for delivery within leisure and community settings, as compared with clinical settings. Across all subscales (pain, function and quality of life) participants have reported an improvement in both leisure/community and clinical settings after attending the programme. In addition, baseline and follow-up measures are similar across both settings, meaning that the effectiveness of ESCAPE-pain in improving these outcomes does not differ when delivered outside of a clinical environment.

Participant retention rates for the ESCAPE-pain programme for knees and hips

We measure the number of ESCAPE-pain participants who complete the programme which means they have attended at least 75% of the sessions. The graph illustrates the average retention rate for the programme, from 2021-2023.

These are combined retention rates for ESCAPE-pain for knees/hips programmes as well as ESCAPE-pain for backs.

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