Chronic Pain Management In Primary Care Using Behavioral Health Consultants

Description

The purpose of this randomized pragmatic trial is to assess the effect of monthly booster contacts on long-term Brief Cognitive Behavioral Therapy for Chronic Pain (BCBT-CP) pain outcomes compared to BCBT-CP without a booster in 716 Military Health Systems (MHS) beneficiaries referred to a Behavioral Health Consultant (BHC) for pain management using BCBT-CP. Patients will be randomly assigned to receive either standard BCBT-CP (working with a BHC in the medical home clinic) or standard BCBT-CP with adjunctive monthly booster contacts. Additionally, patient participants and clinic providers and staff will be offered the opportunity to participate in separate post-treatment Focus Groups using a semi-structured interview format designed to assess the usability, ease of use, perceived effectiveness, helpfulness, and barriers to the pain management intervention. Patient participants will be assessed 3-, 6-, 12- and 18-Months following their first appointment for BCBT-CP. Prospective data will be supplemented by a national data pull in collaboration with the Defense Health Agency and the Uniformed Services University Center for Rehabilitation Sciences Research. Pulled data will include a national deidentified dataset of electronic health record data for all individuals treated in the military health system who had access to a Behavioral Health Consultant for the treatment under study in this trial.

Conditions

Chronic Pain

Study Overview

Study Details

Study overview

The purpose of this randomized pragmatic trial is to assess the effect of monthly booster contacts on long-term Brief Cognitive Behavioral Therapy for Chronic Pain (BCBT-CP) pain outcomes compared to BCBT-CP without a booster in 716 Military Health Systems (MHS) beneficiaries referred to a Behavioral Health Consultant (BHC) for pain management using BCBT-CP. Patients will be randomly assigned to receive either standard BCBT-CP (working with a BHC in the medical home clinic) or standard BCBT-CP with adjunctive monthly booster contacts. Additionally, patient participants and clinic providers and staff will be offered the opportunity to participate in separate post-treatment Focus Groups using a semi-structured interview format designed to assess the usability, ease of use, perceived effectiveness, helpfulness, and barriers to the pain management intervention. Patient participants will be assessed 3-, 6-, 12- and 18-Months following their first appointment for BCBT-CP. Prospective data will be supplemented by a national data pull in collaboration with the Defense Health Agency and the Uniformed Services University Center for Rehabilitation Sciences Research. Pulled data will include a national deidentified dataset of electronic health record data for all individuals treated in the military health system who had access to a Behavioral Health Consultant for the treatment under study in this trial.

Targeting Chronic Pain in Primary Care Settings Using Behavioral Health Consultants, A Randomized Pragmatic Trial

Chronic Pain Management In Primary Care Using Behavioral Health Consultants

Condition
Chronic Pain
Intervention / Treatment

-

Contacts and Locations

Bethesda

Uniformed Services University for the Health Sciences, Bethesda, Maryland, United States, 20814

Fort Hood

Carl R. Darnall Army Medical Center, Fort Hood, Texas, United States, 76544

San Antonio

University of Texas Health Science Center San Antonio, San Antonio, Texas, United States, 78229

San Antonio

Wilford Hall Ambulatory Surgical Center, San Antonio, Texas, United States, 78236-9908

San Antonio

Brooke Army Medical Center, San Antonio, Texas, United States, 78257

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • 1. DoD/MHS beneficiary (including active duty service members, veterans, and family members) age 18 and older.
  • 2. Presenting with a chronic pain complaint (pain occurring more days than not over the past three months that is ongoing at the time of baseline evaluation).
  • 3. Referred for BCBT-CP with a BHC by a Primary Care provider.
  • 4. Speaks and reads/understands English well enough to fully participate in the intervention and to reliably complete assessment measures.
  • 1. Scheduled for a planned pain-related surgery or pain intervention within 6 weeks of enrollment (because the intervention may obscure BCBT-CP outcomes).
  • 2. Inability or unwillingness of individual to give written informed consent.
  • 3. Experiencing another health problem of higher priority for care or that prohibits ability to attend BCBT-CP or research appointments.
  • 1. BHC trained to deliver care according to the Chronic Pain Clinical Pathway
  • 2. Clinic providers/staff caring for patient participants enrolled in this study

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

The University of Texas Health Science Center at San Antonio,

Donald J McGeary, PhD, PRINCIPAL_INVESTIGATOR, UT Health San Antonio

Study Record Dates

2027-01