Evaluation of Stepped Care for Chronic Pain in Iraq/Afghanistan Veterans (ESCAPE)
| Status: | Archived |
|---|---|
| Conditions: | Back Pain, Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
Evaluation of Stepped Care for Chronic Pain in Iraqi/Afghanistan Veterans
The purpose of this study is to determine if a stepped-care intervention makes pain symptoms
better and reduces activity limitations because of pain. Our two primary hypotheses are that
in OIF/OEF veterans with chronic pain:
1. Stepped care is more effective than usual care in reducing pain-related disability
2. Stepped care is more effective than usual care in reducing psychological distress
Through the Evaluation of Stepped Care for Chronic Pain (ESCAPE) trial we aim to develop and
test a stepped-care intervention to improve functional and work-related outcomes in
Operation Iraqi Freedom/Operation Enduring Freedom veterans with chronic musculoskeletal
pain. Stepped-care involves starting with lower intensity, less costly treatments initially
(Step 1) and "stepping up" to more intensive, costly, or complex treatments in patients with
inadequate response (Step 2). The study design will be a randomized controlled trial. The
stepped care approach will involve 12 weeks of a pain self-management program in Step 1
followed by 12 weeks of brief cognitive behavioral therapy in participants with inadequate
improvement in pain-related disability (Step 2). Patients treated in usual care will be the
control group. Thus, the primary objective of the ESCAPE trial is to conduct a randomized
controlled trial to compare the effectiveness of a stepped care intervention vs. usual care
in OIF/OEF veterans with chronic and disabling musculoskeletal pain and evaluate the impact
of this intervention on pain-related disability, work function, psychological distress, and
secondary outcomes.
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