Evidence-Based Multidimensional Pain Self-Management Planning: Personalized by and for Veterans via Web-Based Application

慢性下腰痛在退伍军人中非常普遍，而且往往对药物产生抗药性 管理，因此需要非药理学的管理。对于许多患者来说， 最有效的方法是综合运用多种疗法进行疼痛管理。 解决：身体、精神、身心、睡眠、安全和环境需求。终极的 结果是制定了一个协调的、基于证据的疼痛多维计划 为每个患者量身定做的自我管理(C-MEPP)。这种方法虽然有效，但非常有效。 资源密集，受到成本和卫生系统因素的严重制约。 我们的目标是开发一款基于Web的移动应用程序(App)，为退伍军人提供即时反馈 寻求制定自己的痛苦自我管理计划。这将代表一个新颖的、可扩展的、 退伍军人主导的慢性下腰痛解决方案与退伍军人管理局的在线战略目标保持一致 导航器工具…让退伍军人有权做出决定。我们专注于转会 初级保健背景下的循证实践知识，以帮助退伍军人和 他们的医疗保健提供者在疼痛恶化之前有效地管理疼痛。我们已经这么做了 利用以用户为中心的设计原则开发了App原型，以优化用户 经验。我们的首要目标是为退伍军人开发和试运行一款基于Web的应用程序，包括 老年退伍军人和女性退伍军人，旨在增强每个人在痛苦自我管理方面的能力 规划：提供关于循证多维的访问和数据驱动的指导 行为改变。我们的第二个目标是收集以患者为中心的试点数据 康复效果，如：活动增加，睡眠时间增加，疼痛减轻 干预和更好的生活质量；通过使用App和参与痛苦自我 管理规划。 该项目汇集了熟练的运动生理学家、经验丰富的疼痛和 睡眠临床心理学家、疼痛专家、临床教育工作者、老年医生、妇女健康 提供商和技术设计专家创建一条强大的知识新管道 转给患者和提供者。以整体健康和综合方法为基础， 护理原则、药学实践、物理治疗和营养也包括在 应用程序。我们是一个跨专业的专注于疼痛的团队，将可用的最好的 关于退伍军人和他们手中疼痛的非药物治疗的信息 初级保健提供者。我们的愿景是改善患有慢性下腰痛的退伍军人的生活， 改善获取知识和资源的途径，并让退伍军人有能力规划自己的计划 尽管慢性腰痛，但通向更好、更有成就感的生活之路。

Chronic low back pain is highly prevalent in Veterans, and is often resistant to pharmacological management so that non-pharmacological management is required. For many patients, the most effective approach is comprehensive pain management incorporating multiple therapies addressing: physical, mental, mind-body, sleep, safety, and environmental needs. The ultimate outcome is the development of a coordinated multidimensional evidence-based plan for pain self-management (C-MEPPS) tailored to each patient. This approach, while effective, is highly resource intensive and severely constrained by cost and health system factors. Our goal is a mobile web-based application (App) that provides immediate feedback to Veterans seeking to develop their own pain self-management plan. This will represent a novel, scalable, Veteran-driven solution to chronic low back pain aligned with VA strategic objectives ‘online navigator tools…empowers Veterans to make decisions.’ We are focused on transferring knowledge about evidence-base practices into the primary care context to help Veterans and their healthcare providers manage pain effectively- before it gets worse. We have already developed the App prototype utilizing User-Centered Design principles to optimize the user experience. Our first aim is to develop and pilot test a web-based App for Veterans, including older Veterans and women Veterans, designed to empower each in pain self-management planning: providing access and data-driven guidance about evidence-based multidimensional behavior change. Our second aim is to gather pilot data targeting patient-centered and rehabilitative outcomes such as: increased activity, more sleep time, decreased pain interference and better quality of life; through use of the App and engagement in pain self- management planning. This project brings together the expertise of skilled exercise physiologists, experienced pain and sleep clinical psychologists, pain specialists, clinical educators, geriatricians, women’s health providers, and technology design experts to create a powerful new pipeline for knowledge transfer to patients and providers. Grounded in whole health and integrative approaches, nursing principles, pharmacy practices, physical therapy, and nutrition are also included in the App. We are working as an interprofessional pain-focused team to put the best-available information about non-pharmacological treatments for pain into the hands of Veterans and their primary care providers. Our vision is to improve the lives of Veterans with chronic low back pain, improving access to knowledge and resources and giving Veterans the power to plan their own path to better, more fulfilling living despite chronic low back pain.