Co-Operative Pain Education and Self-management (COPES) Expanding Treatment for Real-World Access (ExTRA): Pragmatic Trial Protocol.
Co-Operative Pain Education and Self-management (COPES) Expanding Treatment for Real-World Access (ExTRA): Pragmatic Trial Protocol.
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DOI：
10.1093/pm/pnaa365
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发表时间：
2020-12-12
期刊：
影响因子：
--
通讯作者：
Higgins DM
中科院分区：
文献类型：
--
作者：
Heapy AA;Driscoll MA;Buta E;LaChappelle KM;Edmond S;Krein SL;Piette JD;Mattocks K;Murphy JL;DeBar L;MacLean RR;Ankawi B;Kawecki T;Martino S;Wagner T;Higgins DM
鉴于慢性疼痛认知行为疗法 (CBT-CP) 存在障碍，这项务实的优越性试验将确定针对患有肌肉骨骼疼痛的退伍军人，解决这些障碍的远程 CBT-CP 干预是否优于面对面的 CBT-CP 和其他同步形式的 CBT-CP。这项务实的试验将异步形式的 CBT-CP（使用交互式语音应答 (IVR) 允许患者在家中参与 (IVR CBT-CP)）与退伍军人事务部 (VA) 临床医生提供的同步 CBT-CP 进行了比较。九个 VA 医疗中心患有慢性肌肉骨骼疼痛的退伍军人（n=764；50% 男性）将参加。主要结果是治疗后（4 个月）的疼痛干扰。治疗后还测量次要结果，包括疼痛强度、抑郁症状严重程度、睡眠、自我效能和变化的整体印象。在可能的情况下，通过电子健康记录提取来收集结果，并通过 IVR 呼叫收集其余测量值以维持盲法。将收集定量和定性过程评估指标来评估与实施相关的因素。将进行预算影响分析。这项务实的试验比较了现实环境中两种形式的 CBT-CP 的结果、成本和实施情况。试验结果可用于指导与这些干预措施及其在卫生系统中的使用相关的未来政策和实施工作。如果其中一种干预措施效果更好，则可以将资源用于这种方式。如果两种治疗方法均有效，则在转诊时将优先考虑患者偏好和医疗保健系统因素。讨论了 COVID-19 对治疗提供和试验结果的影响。
Given access barriers to cognitive behavioral therapy for chronic pain (CBT-CP), this pragmatic superiority trial will determine whether a remotely delivered CBT-CP intervention that addresses these barriers outperforms in-person and other synchronous forms of CBT-CP for veterans with musculoskeletal pain. This pragmatic trial compares an asynchronous form of CBT-CP that uses interactive voice response (IVR) to allow patients to participate from their home (IVR CBT-CP) with synchronous CBT-CP delivered by a Department of Veterans Affairs (VA) clinician. Veterans (n=764; 50% male) with chronic musculoskeletal pain throughout nine VA medical centers will participate. The primary outcome is pain interference after treatment (4 months). Secondary outcomes, including pain intensity, depression symptom severity, sleep, self-efficacy, and global impression of change, are also measured after treatment. Where possible, outcomes are collected via electronic health record extraction, with remaining measures collected via IVR calls to maintain blinding. Quantitative and qualitative process evaluation metrics will be collected to evaluate factors related to implementation. A budget impact analysis will be performed. This pragmatic trial compares the outcomes, cost, and implementation of two forms of CBT-CP as delivered in the real-world setting. Findings from the trial can be used to guide future policy and implementation efforts related to these interventions and their use in the health system. If one of the interventions emerges as superior, resources can be directed to this modality. If both treatments are effective, patient preferences and health care system factors will take precedence when making referrals. Implications of COVID-19 on treatment provision and trial outcomes are discussed.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
4.5
作者：
Sullivan, Sean D.;Mauskopf, Josephine A.;Shau, Wen-Yi
通讯作者：
Shau, Wen-Yi
影响因子：
4.8
作者：
Bastien, Celyne H.;Vallieres, Annie;Morin, Charles M.
通讯作者：
Morin, Charles M.
影响因子：
7.4
作者：
Jensen, MP;Keefe, FJ;Turner, JA
通讯作者：
Turner, JA
影响因子：
5.7
作者：
Krebs, Erin E.;Lorenz, Karl A.;Bair, Matthew J.;Damush, Teresa M.;Wu, Jingwei;Sutherland, Jason M.;Asch, Steven M.;Kroenke, Kurt
通讯作者：
Kroenke, Kurt