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Contemporary clinical trials v.67, 2018년, pp.91 - 99   SCI SCIE
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Interdisciplinary team-based care for patients with chronic pain on long-term opioid treatment in primary care (PPACT) – Protocol for a pragmatic cluster randomized trial

DeBar, Lynn (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; Benes, Lindsay (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; Bonifay, Allison (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; Deyo, Richard A. (Oregon Health and Science University, School of Medicine, Portland, OR, United States ) ; Elder, Charles R. (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; Keefe, Francis J. (Duke University, School of Medicine, Durham, NC, United States ) ; Leo, Michael C. (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; McMullen, Carmit (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; Mayhew, Meghan (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; Owen-Smith, Ashli (Georgia State University, School of Public Health, Atlanta, GA, United States ) ; Smith, David H. (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ; Trinacty, Connie M. (Kaiser Permanente Center for Health Research, Honolulu, HI, United States ) ; Vollmer, William M. (Kaiser Permanente Center for Health Research, Portland, OR, United States ) ;
  • 초록  

    Abstract Background Chronic pain is one of the most common, disabling, and expensive public health problems in the United States. Interdisciplinary pain management treatments that employ behavioral approaches have been successful in helping patients with chronic pain reduce symptoms and regain functioning. However, most patients lack access to such treatments. We are conducting a pragmatic clinical trial to test the hypothesis that patients who receive an interdisciplinary biopsychosocial intervention, the Pain Program for Active Coping and Training (PPACT), at their primary care clinic will have a greater reduction in pain impact in the year following than patients receiving usual care. Methods/design This is an effectiveness-implementation hybrid pragmatic clinical trial in which we randomize clusters of primary care providers and their patients with chronic pain who are on long-term opioid therapy to 1) receive an interdisciplinary behavioral intervention in conjunction with their current health care or 2) continue with current health care services. Our primary outcome is pain impact (a composite of pain intensity and pain-related interference) measured using the PEG, a validated three-item assessment. Secondary outcomes include pain-related disability, patient satisfaction, opioids dispensed and health care utilization. An economic evaluation assesses the resources and costs necessary to deliver the intervention and its cost-effectiveness compared with usual care. A formative evaluation employs mixed methods to understand the context for implementation in the participating health care systems. Discussion This trial will inform the feasibility of implementing interdisciplinary behavioral approaches to pain management in the primary care setting, potentially providing a more effective, safer, and more satisfactory alternative to opioid-based chronic pain treatment. Clinical Trials Registration Number: NCT02113592


  • 주제어

    Chronic pain .   Interdisciplinary treatment .   Pragmatic clinical trial.  

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