Pilot of Peers Enhancing Engagement for Pain Services
同行加强疼痛服务参与试点
基本信息
- 批准号:10700218
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-02-01 至 2025-01-31
- 项目状态:未结题
- 来源:
- 关键词:Active ListeningAddressBehavioralCaringCenters for Disease Control and Prevention (U.S.)CertificationChronicChronic DiseaseClinicClinicalClinical TrialsDataDevelopmentDistressEffectivenessElementsEmployeeEnrollmentGoalsGuidelinesHealthcareIndividualInterventionManualsMedicineMental HealthMethodologyOpioidOutcomeOutcome MeasurePainPain managementPatientsPersistent painPersonal SatisfactionPharmaceutical PreparationsPhysical activityPrimary CareProspective StudiesProtocols documentationPublic HealthQuality of lifeRandomized, Controlled TrialsRecommendationResearchResearch PersonnelResourcesRoleSelf ManagementServicesSpecialistSubstance Use DisorderTestingTimeTrainingVeteransVeterans Health AdministrationWalkingWorkacceptability and feasibilityaddictionarmchronic painchronic pain managementchronic pain patientcostdaily functioningdiabetes self-managementdisabilityexperiencefunctional improvementimprovedinnovationintervention mappingintervention refinementmedical appointmentmeetingsmotivational enhancement therapymultidisciplinarymultimodalitynon-cancer chronic painnon-opioid analgesicopioid misuseopioid overdoseopioid therapypain reductionpain self-managementpain-related disabilitypatient engagementpatient navigatorpedometerpeerpeer supportphysical conditioningpilot testpilot trialrandomized trialrehabilitation researchresearch and developmentskillsteam-based caretherapy developmentwhole health
项目摘要
Background: Chronic pain, and particularly high-impact chronic pain (that is, pain last three months or longer
that impacts daily functioning in one or more domains) is a leading cause of disability, often associated with
declining functioning, lost days of work, and worsened quality of life. The Veterans Health Administration (VHA)
identified both improved pain management and reduced opioid-related harms as national priorities, with an
emphasis on improving function and pain-related disability. Peer specialists may be an untapped and valuable
resource to support Veterans with chronic pain and enhance the effectiveness of pain treatment. Peer
specialists are individuals with lived experience who work with Veterans to encourage patient activation and
help patients manage chronic conditions. Peer specialists work in a variety of clinical settings, most commonly
mental health clinics, and are well-suited to help patients who are harder to engage in services or those
needing more support to promote self-management strategies. Peer support is particularly effective for patients
with more severe illnesses or higher levels of distress, and thus may be helpful for Veterans with high-impact
chronic pain.
Significance: Chronic pain is one of the most common and costly problems among Veterans using VHA
healthcare. VHA guidelines for pain management and opioid therapy encourage non-pharmacological pain
management strategies (NPMs) and non-opioid medications for chronic pain management. However, NPMs
that emphasize improved pain-related function are often underutilized. Addressing pain management and
opioid misuse are VHA priorities and this research directly aligns with VHA Rehabilitation Research &
Development (RR&D) priorities, including promotion of non-pharmacological activity-based interventions for
chronic pain, impacting outcomes such as pain; it also aligns with RR&D’s broader goal of maximizing
Veteran’s function and quality of life.
Innovation & Impact: The role of peer specialists in VHA is rapidly expanding beyond traditional mental health
settings, leading to an urgent need for additional research to understand how best to use peer specialists’
unique skills to enhance care for Veterans in a wider range of settings. No studies to date have evaluated the
use of peer specialists to support improvements in pain-related function among Veterans with chronic pain.
The current proposal is innovative because it proposes, for the first time, using peer specialists to focus on
pain management. If proven effective, this project could pave the way for widespread implementation of peer
specialists into new settings where they can support pain management.
Specific Aims: The specific aims of this project are to (1) Use intervention mapping (IM) to refine our
intervention, Peers Enhancing Engagement for Pain Services (PEEPS) and (2) Pilot test the feasibility and
acceptability of PEEPS and collect function-focused outcome measures for use in a rigorous prospective
study.
Methodology: After refining the intervention protocol using intervention mapping, we propose a single arm
pilot trial where we will enroll 24 Veterans with high-impact chronic pain to participate in PEEPS, collecting
data at baseline and three-months post baseline. Our primary focus will be feasibility and acceptability; we will
also collect data on pain-related function, activity (steps walked, using pedometers), and well-being/quality of
life.
Next Steps/Implementation: These data will inform the development of a larger proposal testing PEEPS in a
multicenter randomized controlled trial.
背景:慢性疼痛,特别是高强度慢性疼痛(即持续三个月或更长时间的疼痛)
项目成果
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