Improving the Management of Chronic Pain in Primary Care
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Chronic Pain, Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 10/14/2018 |
| Start Date: | July 2016 |
| End Date: | September 2019 |
There are an estimated 100 million Americans with chronic pain. The enormity of the problem
at the societal level is staggering, not simply in terms of its sheer prevalence but also the
societal costs, including health care expenditures, disability compensation, lost
productivity, and lost employment potential. The pharmacological focus in treatment tends to
give patients with chronic pain a negative stereotype as many are viewed as drug seeking, or
worse, they are perceived to have an imaginary illness. It is argued that these stigmas not
only negatively affect the patients' healthcare experience, but also perpetuate maladaptive
coping. In addition, it is suggested that reliance on pharmacological approaches have
contributed to the rate of overdoses from prescribed opioids. In order to address this burden
facing society, patients need opportunities to foster a sense of self-efficacy to manage
their pain, as well as improve their healthcare experience by allowing them to dialogue with
their clinician openly and freely about their chronic pain, and coping strategies.
This study is designed to explore the impact of an intervention using photo-elicitation
(based on Photovoice) and online group support (via Facebook) on participants' overall
experience of chronic pain and patient-identified areas of function. Photovoice participants
will utilize cameras that enable them to record issues related to their experiences, and
subsequently display them. This method serves as an empowering tool to connect participants
to key stakeholders in the community, facilitates change and opportunities that otherwise
would not be available to marginalized groups.
at the societal level is staggering, not simply in terms of its sheer prevalence but also the
societal costs, including health care expenditures, disability compensation, lost
productivity, and lost employment potential. The pharmacological focus in treatment tends to
give patients with chronic pain a negative stereotype as many are viewed as drug seeking, or
worse, they are perceived to have an imaginary illness. It is argued that these stigmas not
only negatively affect the patients' healthcare experience, but also perpetuate maladaptive
coping. In addition, it is suggested that reliance on pharmacological approaches have
contributed to the rate of overdoses from prescribed opioids. In order to address this burden
facing society, patients need opportunities to foster a sense of self-efficacy to manage
their pain, as well as improve their healthcare experience by allowing them to dialogue with
their clinician openly and freely about their chronic pain, and coping strategies.
This study is designed to explore the impact of an intervention using photo-elicitation
(based on Photovoice) and online group support (via Facebook) on participants' overall
experience of chronic pain and patient-identified areas of function. Photovoice participants
will utilize cameras that enable them to record issues related to their experiences, and
subsequently display them. This method serves as an empowering tool to connect participants
to key stakeholders in the community, facilitates change and opportunities that otherwise
would not be available to marginalized groups.
This is a multi-site study occurring between the University of Missouri, and the American
Academy of Family Physicians National Research Network (NRN). The University of Missouri will
be responsible for the following:
- Coordinating the approval of initial protocol as well as subsequent amendments.
- Ensure that each site is using the correct version of the protocol.
- Serve as the study contact.
- Participate in the selection of qualified sites for participation (the NRN will be
responsible for recruitment and randomization. This process will be overseen by MU).
- Monitor progress and oversee all conduct of the study at participating sites.
- Responsible for the data analysis, reporting, integrity, and accuracy of data.
There will be one protocol document, and each site will utilize this document. The lead site
(MU) will develop the informed consent, which includes language that data will be shared with
the NRN.
The NRN will be the Institutional Review Board (IRB) of record for the 18 practices recruited
to participate within the NRN, and will provide a letter of authorization and final IRB
approval to the lead PI (MU).
The study will test if a photo elicitation intervention combined with access to online
community support and a chronic pain guideline can improve a 3-item measure of chronic pain
[the PEG score: Pain intensity (P), Enjoyment of Life (E), and General Activity (G)] and a
patient-identified area of function, compared to a group who receive the guideline alone.
Academy of Family Physicians National Research Network (NRN). The University of Missouri will
be responsible for the following:
- Coordinating the approval of initial protocol as well as subsequent amendments.
- Ensure that each site is using the correct version of the protocol.
- Serve as the study contact.
- Participate in the selection of qualified sites for participation (the NRN will be
responsible for recruitment and randomization. This process will be overseen by MU).
- Monitor progress and oversee all conduct of the study at participating sites.
- Responsible for the data analysis, reporting, integrity, and accuracy of data.
There will be one protocol document, and each site will utilize this document. The lead site
(MU) will develop the informed consent, which includes language that data will be shared with
the NRN.
The NRN will be the Institutional Review Board (IRB) of record for the 18 practices recruited
to participate within the NRN, and will provide a letter of authorization and final IRB
approval to the lead PI (MU).
The study will test if a photo elicitation intervention combined with access to online
community support and a chronic pain guideline can improve a 3-item measure of chronic pain
[the PEG score: Pain intensity (P), Enjoyment of Life (E), and General Activity (G)] and a
patient-identified area of function, compared to a group who receive the guideline alone.
Inclusion Criteria:
Patients will need to meet the following criteria in order to participate in the study:
- they must be between the ages of 18-75
- they must have an established care relationship with the practitioner (having had at
least two previous visits for chronic pain of at least 6 months' duration)
- they must read and understand English
- they must be willing to sign a consent. Patients must have a device to take pictures
(e.g., camera, phone, or tablet) and access to the internet in order to complete
REDcap (the online data collection tool we will use to capture quantitative data in
order to assess intervention impact), and participate in the online discussions via
Facebook.
Exclusion Criteria:
- No terminal illness, and/or a life expectancy of < 1yr.
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