Pain Management Teams Using Whole Health to Optimize Function and Safety in Veterans: The TEAMWORK Trial
VA Office of Research and Development
Summary
The focus of this study is to determine whether adding Whole Health Coaching (WHC) improves pain care among adults with chronic pain and who are currently working with a pain management team (PMT) at the VA.
Description
This multisite pragmatic effectiveness-implementation hybrid type 2 trial will randomize 432 patients to compare Pain Management Team - Usual Care (PMT-UC) vs. Pain Management Team Usual Care + Whole Health Coaching (PMT-WHC) on the primary composite outcome of pain-related interference and opioid safety. The investigators will also evaluate the impact of PMT-WHC on buprenorphine initiation and maintenance, evaluate implementation facilitation strategies for building and sustaining PMTs, and conduct a budget impact analysis. The primary study goal is to evaluate the effectiveness of adding Wh…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: INCLUSION CRITERIA: 1. High-impact chronic pain (defined using the Graded Chronic Pain Scale - Revised). -AND- 2. Active prescription for LTOT (\>90 days continuous prescription). -AND- 3. Exhibit evidence of at least ONE opioid safety concern (\*indicators of opioid safety concerns described below). * Opioid safety concerns for inclusion purposes include: 1. moderate-to-high dose opioid prescription (morphine equivalent daily dose \>60mg) 2. comorbid conditions that increase the risk of opioids including chronic pulmonary disease (e.g., emphysema, chro…
Interventions
- OtherPain Management Team + Whole Health Coach (PMT-WHC)
Whole Health Coaching (WHC) begins by completing a Personalized Health Inventory (PHI), where progress is evaluated within 8 dimensions of health and wellness. The PHI culminates in defining personal values and overall goals for health and wellness (i.e., "What do you want your health for?"). This is used to create goals for a Personal Health Plan. The Plan emphasizes self-management strategies to manage pain. After the Plan is developed, ongoing support is provided from the Coach through 8 coaching sessions over approximately 5 months.
- OtherPain Management Team-Usual Care (PMT-UC)
Pain Management Team-Usual Care (PMT-UC) involves working with VA PMTs that includes working with PMTs comply with legislation requiring each medical center to have PMTs with expertise in pain, addiction, behavioral approaches, and rehabilitation approaches. PMTs will conduct multidisciplinary intakes (at least two provider types) with biopsychosocial assessments for all new patients. Follow-up care will be determined by the PMTs based on what is clinically indicated (with recommended minimum medication management follow ups at 1- 3- and 6-months for patients making medication changes).
Locations (5)
- Birmingham VA Medical Center, Birmingham, ALBirmingham, Alabama
- Central Arkansas Veterans Healthcare System , Little Rock, ARLittle Rock, Arkansas
- Rocky Mountain Regional VA Medical Center, Aurora, COAurora, Colorado
- VA Connecticut Healthcare System West Haven Campus, West Haven, CTWest Haven, Connecticut
- Boise VA Medical Center, Boise, IDBoise, Idaho