Co-Operative Pain Education and Self-management (COPES) Expanding Treatment for Real-World Access (ExTRA): Pragmatic Trial Protocol.

Autor:	Heapy AA; VA Connecticut Healthcare System, West Haven, Connecticut.; Yale University School of Medicine, New Haven, Connecticut., Driscoll MA; VA Connecticut Healthcare System, West Haven, Connecticut.; Yale University School of Medicine, New Haven, Connecticut., Buta E; Yale University School of Medicine, New Haven, Connecticut., LaChappelle KM; VA Connecticut Healthcare System, West Haven, Connecticut., Edmond S; VA Connecticut Healthcare System, West Haven, Connecticut.; Yale University School of Medicine, New Haven, Connecticut., Krein SL; VA Ann Arbor Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan.; University of Michigan Medical School, Ann Arbor, Michigan., Piette JD; VA Ann Arbor Center for Clinical Management Research, Health Services Research and Development Center of Innovation, Ann Arbor, Michigan.; University of Michigan School of Public Health, Ann Arbor, Michigan., Mattocks K; VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts.; University of Massachusetts Medical School, Worcester, Massachusetts., Murphy JL; US Department of Veterans Affairs Central Office, Washington, District of Columbia.; University of South Florida Morsani College of Medicine, Tampa, Florida., DeBar L; Kaiser Permanente Washington Health Research Institute, Seattle, Washington., MacLean RR; VA Connecticut Healthcare System, West Haven, Connecticut.; Yale University School of Medicine, New Haven, Connecticut., Ankawi B; VA Connecticut Healthcare System, West Haven, Connecticut.; Yale University School of Medicine, New Haven, Connecticut., Kawecki T; VA Connecticut Healthcare System, West Haven, Connecticut.; Yale University School of Medicine, New Haven, Connecticut., Martino S; VA Connecticut Healthcare System, West Haven, Connecticut.; Yale University School of Medicine, New Haven, Connecticut., Wagner T; Palo Alto VA Health Economics Resource Center, Menlo Park, California.; Department of Surgery, Stanford University, Palo Alto, California., Higgins DM; VA Boston Healthcare System, Boston, Massachusetts.; Boston University School of Medicine, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Pain medicine (Malden, Mass.) [Pain Med] 2020 Dec 12; Vol. 21 (12 Suppl 2), pp. S21-S28.
DOI:	10.1093/pm/pnaa365
Abstrakt:	Background: 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. Design: 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. Summary: 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. (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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