Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.

Autor:	George SZ; Duke Clinical Research Institute and Department of Orthopaedic Surgery, Duke University, Durham, North Carolina., Coffman CJ; Department of Biostatistics and Bioinformatics, Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Duke University Medical Center, Durham, North Carolina., Allen KD; University of North Carolina, Chapel Hill, Chapel Hill, North Carolina., Lentz TA; Duke Clinical Research Institute and Department of Orthopaedic Surgery, Duke University, Durham, North Carolina., Choate A; Durham VA Health Care System, Health Services Research & Development, Durham, North Carolina., Goode AP; Department of Orthopaedic Surgery, Duke Clinical Research Institute, Durham, North Carolina., Simon CB; Department of Orthopaedic Surgery, Duke University, Durham, North Carolina., Grubber JM; Durham VA Health Care System, Health Services Research & Development, Durham, North Carolina., King H; Department of Orthopaedic Surgery, Duke University, Durham, North Carolina.; Department of Population Health Sciences, Division of General Internal Medicine, Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Health Services Research & Development, Duke University, Durham, North Carolina., Cook CE; Duke Clinical Research Institute and Department of Orthopaedic Surgery, Duke University, Durham, North Carolina., Keefe FJ; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina., Ballengee LA; Durham VA Health Care System, Health Services Research & Development, Duke University, Durham, North Carolina., Naylor J; Durham VA Health Care System, Mental Illness Research Education and Clinical Center, Duke University, Durham, North Carolina., Brothers JL; Duke Clinical Research Institute, Durham, North Carolina., Stanwyck C; Durham VA Health Care System, Health Services Research & Development, Duke University, Durham, North Carolina., Alkon A; Durham VA Health Care System, Health Services Research & Development, Duke University, Durham, North Carolina., Hastings SN; Durham Center of Innovation to Accelerate Discovery and Practice, Durham VA Health Care System, Geriatric Research, Education and Clinical Center at Durham VAHCS Health Services Research & Development, Durham, North Carolina.; Department of Population Health Sciences, Duke University, Durham, North Carolina.; Department of Medicine, Duke University, Durham, North Carolina, USA.
Jazyk:	angličtina
Zdroj:	Pain medicine (Malden, Mass.) [Pain Med] 2020 Dec 12; Vol. 21 (Suppl 2), pp. S62-S72.
DOI:	10.1093/pm/pnaa348
Abstrakt:	Background: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging development; however, what constitutes best practice for nonpharmacologic management of low back pain (LBP) is largely unknown. Design: The Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) trial is an embedded pragmatic cluster-randomized trial that will examine the effectiveness of two different care pathways for LBP. Sixteen primary care clinics will be randomized 1:1 to receive training in delivery of 1) an integrated sequenced-care pathway or 2) a coordinated pain navigator pathway. Primary outcomes are pain interference and physical function (Patient-Reported Outcomes Measurement Information System Short Form [PROMIS-SF]) collected in the electronic health record at 3 months (n=1,680). A subset of veteran participants (n=848) have consented to complete additional surveys at baseline and at 3, 6, and 12 months for supplementary pain and other measures. Summary: AIM-Back care pathways will be tested for effectiveness, and treatment heterogeneity will be investigated to identify which veterans may respond best to a given pathway. Health care utilization patterns (including opioid use) will also be compared between care pathways. Therefore, the AIM-Back trial will provide important information that can inform the future delivery of nonpharmacologic treatment of LBP. (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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