Pilot of Peers Enhancing Engagement for Pain Services

同行加强疼痛服务参与试点

• 批准号: 10700218
• 负责人: Sara Edmond
• 金额: --
• 依托单位: VA CONNECTICUT HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 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: https://reporter.nih.gov/project-details/10700218
• 关键词: Active Listening; Address; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Certification; Chronic; Chronic Disease; Clinic; Clinical; Clinical Trials; Data; Development; Distress; Effectiveness; Elements; Employee; Enrollment; Goals; Guidelines; Healthcare; Individual; Intervention; Manuals; Medicine; Mental Health; Methodology; Opioid; Outcome; Outcome Measure; Pain; Pain management; Patients; Persistent pain; Personal Satisfaction; Pharmaceutical Preparations; Physical activity; Primary Care; Prospective Studies; Protocols documentation; Public Health; Quality of life; Randomized, Controlled Trials; Recommendation; Research; Research Personnel; Resources; Role; Self Management; Services; Specialist; Substance Use Disorder; Testing; Time; Training; Veterans; Veterans Health Administration; Walking; Work; acceptability and feasibility; addiction; arm; chronic pain; chronic pain management; chronic pain patient; cost; daily functioning; diabetes self-management; disability; experience; functional improvement; improved; innovation; intervention mapping; intervention refinement; medical appointment; meetings; motivational enhancement therapy; multidisciplinary; multimodality; non-cancer chronic pain; non-opioid analgesic; opioid misuse; opioid overdose; opioid therapy; pain reduction; pain self-management; pain-related disability; patient engagement; patient navigator; pedometer; peer; peer support; physical conditioning; pilot test; pilot trial; randomized trial; rehabilitation research; research and development; skills; team-based care; therapy development; whole health

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）