Enabling Self-management
and Coping with Arthritic Pain
using Exercise

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, that significantly improves participant outcomes. All six pilot sites saw mean improvements in participant clinical outcome measures, found ESCAPE-pain for backs beneficial for participants in the self-management of non-specific LBP and have since adopted the programme into regular practice. The programme is now being rolled out further to clinical and leisure sites across the country.

 

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.

 

Real-time Participant Outcomes from the ESCAPE-pain programme for knees and 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 12,000 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).

 

 

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 below illustrates the average retention rate for the programme per quarter, over the past financial year 2019-2020.

* Due to COVID-19, ESCAPE-pain activity in Quarter 4 (January to March 2020) was significantly disrupted meaning that many programmes were terminated early due to the imposed government restrictions and disruption to healthcare services from mid-March. The effects of these impacted the average retention rate for this quarter.

The average retention rate for quarters 1 to 3 is 78%, whilst the annual average drops to 74% when we inlcude the completers in Quarter 4

 

 


Page last reviewed: 19 August 2020. Page last updated: 19 August 2020. Next review date: 1 October 2020