Improving the Treatment of Chronic Pain in Primary Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 401
- 试验地点
- 2
- 主要终点
- Adjusted Change in Pain-related Function (Roland Disability Score)
研究概览
简要总结
The primary objective of this study is to determine to what extent a collaborative intervention improves chronic pain-related outcomes in a VA primary care setting. We will also determine to what extent the intervention affects 1) treatment of co-occurring depression, 2) adherence of providers to guidelines for treating chronic pain, and 3) patient and provider satisfaction and attitudes related to chronic pain treatment.
详细描述
Background:
Chronic pain is very common, and associated with substantial impairment and increased healthcare utilization. Implementation of treatment guidelines has been problematic, and chronic pain remains undertreated. Because of the prevalence of chronic pain among veterans, the VHA created a National Pain Management Strategy and adopted pain as the "5th vital sign."
Objectives:
Our primary objective was to determine to what extent a collaborative intervention improves chronic pain-related outcomes (pain-related function, pain severity and depression severity) in a VA primary care setting over six and 12 months. We also investigated to what extent the intervention affected 1) treatment of comorbid depression, 2) adherence of providers to guidelines for chronic pain, 3) patient and provider satisfaction and attitudes related to chronic pain treatment, and 4) incremental benefit (pain disability-free days) and incremental health services costs.
Methods:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients currently receiving primary care at Portland VAMC
- •Diagnosed musculoskeletal chronic pain condition lasting at least 3 months
- •Currently experiencing moderate to severe symptoms as per screening
- •Willingness to complete 6 and 12 month interviews
- •Regular access to a telephone
排除标准
- •Dementia or cognitive disturbance
- •Diagnoses of fibromyalgia, chronic fatigue or somatization disorder Terminal illness
- •Designated guardian
- •Drug-seeking behavior flag in medical record
研究组 & 干预措施
Assistance with Pain Treatment
Care management intervention including assessment, decision support, patient activation, education and followup, provider education, feedback to providers
干预措施: Assistance with Pain treatment (Behavioral)
Treatment as usual
Treatment as usual
结局指标
主要结局
Adjusted Change in Pain-related Function (Roland Disability Score)
时间窗: 12 months
The Roland Morris Disability Questionnaire has 24 yes or no items. Each item is scored as 0 or 1. Item scores or summed to create total score with range 0 to 24. Higher scores represent greater disability. The Roland Morris has been widely used, has content and construct validity, internal consistency, and responsiveness to change among patients with chronic pain.
次要结局
- Adjusted Change in Depression Severity(12 months)
- Adjusted Change in Pain Interference(12 month)
- Global Impression of Change(12 months)
- Adjusted Change in Health Related Quality of Life(12 months)