Abstract
Background: Chronic pain is defined as pain that persists or recurs for three months or longer. In Alberta, Canada, one in five individuals lives with chronic pain. For years, many patients living with chronic pain in Alberta have faced significant barriers to accessing care(1,2), having to “fight to get what [they] need”(3), and called for change.
The Alberta Virtual Pain Program (AVPP) was developed to address gaps in chronic pain care in the province. Recognizing that chronic pain is physiologically distinct from acute pain, AVPP offers easy and timely access to patient-centered interdisciplinary care and evidence-based non-pharmacological resources.
Approach: Patient engagement has been a cornerstone of the AVPP's development and implementation. The program was developed as a direct response to patient advocacy and shaped through robust collaboration with people with lived experience.
Key examples of collaboration and co-design in the AVPP’s case include:
1.Model of Care Informed by the Patient-to-Patient Research: The proposed model of care for the AVPP was directly informed by patient and community engagement research, led by patient-researchers. This research produced key recommendations for the health delivery system, outlining actionable steps to improve care and support for individuals living with chronic pain(3), which served as the foundation for the AVPP’s design.
2.Advocacy for Change: People with lived experience provided letters of support, which accompanied the AVPP proposal submitted to the government, and participated in meetings with government leaders to advocate for enhanced chronic pain resources in Alberta.
3.Co-Design: People with lived experience actively contributed to the co-design of the AVPP as members of the advisory committee and working groups. They played a key role in determining the structure and content of services, reviewing materials, and shaping program delivery.
4.Continuous Feedback and Improvement: Following the AVPP’s launch, a robust feedback process was established to capture and act on participant experiences. Feedback is collected through anonymous surveys. Participants can also voice their opinions during Peer Support Worker–led group sessions, fostering open dialogue and deeper insights. This feedback is reviewed by the AVPP team to enable timely improvements to the program and prioritize the development of topic-specific programming.
Results: In October 2022, the provincial government announced a plan to start a Provincial Pain Program, the AVPP, and committed funding for its first phase. The AVPP officially launched in April 2024, and within less than six months, over 200 patients have already engaged with its services. Participant feedback has been overwhelmingly positive. For instance, one participant called it an "eye-opener" that has renewed their hope: “The program has helped me validate my mission to start finding ways of healing.”
Implications: The success of the AVPP underscores the critical role of people with lived experience in every phase of health system innovation. By integrating patient voices throughout health system planning, program design, and ongoing refinement, the AVPP is driving meaningful change to addresses gaps in care and ensure the program is responsive to the real and pressing needs of those living with chronic pain.
References:
1.https://doi.org/10.1371/journal.pone.0272638
2.https://www.albertahealthservices.ca/assets/about/scn/ahs-scn-alberta-pain-strategy-executive-summary-2019-24.pdf
3.https://doi.org/10.1136/bmjopen-2023-072048