At a glance
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Improving Veteran Access to Integrated Management of Back Pain: A Pragmatic, Cluster Randomized Trial
In Brief
A clinical study evaluating Pain modulation with physical pain treatment, Telephone delivered self-management counseling for increasing physical activity, and 4 other interventions for Low Back Pain and Veterans Family. Completed, enrolled 1,817 participants across 1 site.
Detailed Summary
The purpose and objective of this pragmatic trial is to examine the effectiveness of two different quality improvement care pathways for low back pain (LBP); a sequenced, integrated care pathway (ICP) and 2) a coordinated, care management pathway (CCP). We will test the central hypothesis that the ICP will reduce pain interference with normal activities and improve physical function, as measured by Patient Reported Outcomes Measurement Information System (PROMIS) Short Form scores when compared to the CCP.
Study Details
Timeline
Interventions
Examples of pain modulation with physical pain treatment include spinal manipulation, massage, or transcutaneous electrical nerve stimulation
Centrally located physical therapy assistants will provide six weeks of telehealth consults to increase physical activity for the patient
Patients with a higher risk of developing chronic or persistent back pain will be identified using the nine question risk stratification start back screening tool (SBST) and will receive six additional weeks of physical activity instructions and additional pain modulation treatments as needed.
the pain navigator will work through a shared decision making process with the patient to determine the preferred treatment protocol
the pain navigator will select only nonpharmacological guideline adherent treatment options for the patient
the pain navigator will work with the referring physician to select only existing VA or non-VA pain management resources for the patient.