PIPPI (Practical Interdisciplinary Pelvic Pain Intervention) Development and delivery of a specialised Interdisciplinary Pain Management Group Program for women with Chronic Pelvic Pain.

Programme development stage An audit of women attending the Christchurch Women’s Hospital Gynaecology Outpatients was undertaken to identify the current unmet needs in this population. An interdisciplinary team of clinicians with special interest in Chronic Pelvic Pain (CPP) was identified from the current Pain Management and Women’s Health services. Additional skills and knowledge was gained by a variety of CPD activities. Existing international pelvic pain PMPs (Pain Management Programme) were contacted and information gathered via email contact, and by site visits. The PIPPI PMP modules were developed collaboratively by the interdisciplinary team, covering all aspects of self-management as delivered within the current PMPs and incorporating themes which are specific to CPP. Joint planning sessions ensured that key themes and consistent messages are continued throughout the program. Programme delivery stage Following international guidelines which recommend a medium intensity group program to contain 8-12 participants, and provide 24-60 hours over 6-8 weeks from two clinicians per module. We aim to recruit up to 12 women per group. The intervention will be 24 hours of group program- 4 hours, once a week for 6 weeks. Four consecutive groups will be completed during this pilot programme, over a six-month period. The intervention will be delivered to the group by a team of clinicians, including a doctor, pain management psychologist, dietician, pain management physiotherapist, women’s health physiotherapist, and pain management nurse. The sessions will be face to face delivery in small based in a meeting room at a hospital, via interactive workshops. Each module will be 45minutes duration, covering five topics each week. The content will be manualised – for both clinician and participants, in order to maintain consistency of topic delivery. ‘Homework’ will be set for participants to complete between weekly sessions, for example a food diary to complete, or relaxation exercises to practice. Women will be asked to attend all six weeks of the programme, and attendance monitored by the clinicians delivering the modules. Absence from more than one week may lead to removal from the programme (this is outlined in the participant information and consent information). Modules will be grounded in a cognitive behavioural model and include: Pain Neuroscience education (both didactic teaching and small group exercises); gentle graded supervised group exercise classes; relaxation, sleep and stress management; communication and problems solving; and dietary advice. Self-complete paper based questionnaires will be administered at the commencement and end of the program, and for follow up at 3, 6 and 12 months.