Background Persistent pain is a public health crisis. Demand for services frequently exceeds supply and many individuals miss out on timely treatment resulting in longer than recommended wait times. The Interdisciplinary Persistent Pain Centre (IPPC) (Queensland, Australia) implemented a Treatment Access Pathway (TAP), an allied health first point of contact model of care to allow patients access to empirically supported allied health treatment without Pain Specialist assessment. The primary aim of this research project is to understand the clinical and cost effectiveness of TAP in a real-world setting. Method: Participants referred to the IPPC are randomly allocated to treatment or waitlist control groups and self-report and objective physical outcome measures are collected at baseline and 6 months’ time. A total of 196 patients will be recruited for the study (treatment group, n=98 and control group, n=98) to allow a 20% attrition rate to gain 156 participants for the study. Discussion: The results of this study will determine the clinical outcomes and cost effectiveness of the TAP as a model of care to inform future clinical decision making and program development. Ethics approval was provided by the Research Governance Office at Gold Coast Hospital and Health Service (RGOGCHHS) on the 19/10/2016 (HREC/16/QGC/156).

Background Chronic pain is a significant health problem worldwide and requires a biopsychosocial treatment approach. Access to traditional pain medicine specialist services is limited and innovative treatment models are required to support patients in tertiary care. The study evaluated the clinical effectiveness and safety of the Treatment Access Pathway (TAP), an allied health expanded scope model of care which included innovative group assessment and collaboration with patients to create individualized treatment plans. Methods One hundred and eighty‐one patients referred to a tertiary level chronic pain service were randomly allocated to either the TAP or the waitlist study groups. Primary (pain interference) and secondary outcome measures were collected at recruitment and again at 6 months. Per‐protocol analyses were utilized due to high participant attrition (46% across groups). Results The TAP group reported greater reductions in pain interference at 6 months than waitlist group (0.9, 95% CI: 0.2–1.6), with more than half of the TAP group (52%) reporting clinically significant improvement. In addition, statistically significant differences between the TAP and waitlist groups were observed for objective measurements of walking endurance (5.4 m, 95% CI: 1.7–9.1); and global impressions of change (1.4 unit decrease, 95% CI: 1–1.9). Nil adverse events were recorded. Conclusions The study suggests that an expanded scope allied health model of care prioritizing patient choice and group‐based interventions provides modest benefits for tertiary‐referral chronic pain patients. TAP warrants further investigation as a potentially viable alternative for tertiary healthcare where traditional pain services are unavailable or have long waiting lists. Significance The study tests effectiveness and safety of an expanded scope allied health‐led chronic pain program. Despite a high attrition rate, the study showed reduced pain interference and increased physical function in those who completed the protocol. The results are promising and support introduction of this model as an adjunct to existing traditional chronic pain models of care, with a particular focus on improving participant retention in the program. Additionally, the model of care can be used as a standalone chronic pain model of care where no other pain management resources are available. The study was registered on ANZCTR (Trial ID: ACTRN12617001284358).