Résumé
Chronic pain affects a large part of the population, with considerable consequences on the quality of life, inducing physical and psycho-social vulnerabilities. It causes direct costs through treatments, and indirect costs through reduced productivity of the patients. Reciprocally, pain is impacted by psychological and socioeconomic factors. Chronic conditions can be improved by reducing modifiable risk factors. Several education programs, such as theChronic Disease Self-Management Program (CDSMP), have shown benefits of patient empowerment and health literacy. However, in vulnerable populations, the impact of such programs has received little attention, although prevalence of chronic conditions is significantly higher. The present research is the first multicentric evaluation of the ability of the CDSMP to improve pain. It is based on the project EFFICHRONIC, involving socioeconomically vulnerable participants, with a chronic condition, in five European countries. Adjusting for a wide range of variables, and using multiple imputation methods for more than a thousand participants, we found that pain was significantly lowered after the intervention (in both complete cases and imputed datasets). Although the effect size was weak, our results support the idea that such training programs are able to improve pain and alleviate its consequences on quality of life, particularly in vulnerable populations. The benefits of the intervention appeared to be greater for younger participants, and those with a higher education level. Such specificities of our target population reinforce the idea that the recognition of the social determinants of health is essential.