IMproving Pain Using Peer RE-inforced Self-management Skills (IMPPRESS)
The overall purpose of this pilot study is to conduct a formative evaluation of (veteran)peer delivery of a chronic pain self-management program to veterans with chronic musculoskeletal pain.
Our specific aims are as follows:
Aim 1: Evaluate the feasibility of identifying, recruiting, training, and retaining veteran peers to implement a self-management program for chronic pain.
Aim 2: Identify facilitators and barriers to peer-delivery of a chronic pain self-management program.
Aim 3: Convene an expert panel to review the results of Aims 1 and 2, help to interpret the results, and plan next steps.
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Improving Pain Using Peer RE-inforced Self-management Skills (IMPPRESS)|
- Pain/Enjoyment of Life/General Activity [ Time Frame: Change from baseline to 4 month assessment ] [ Designated as safety issue: No ]3-item version of the Brief Pain Inventory. Possible range: 0-30. 0=no pain/interference, 30=maximum pain/interference. Thus lower values represent a better outcome.
- Pain Catastrophizing Scale [ Time Frame: Baseline and 4 month assessment (final assessment) ] [ Designated as safety issue: No ]Pain Catastrophizing Scale. 13-item scale. Possible score range 0-52, with lower scores representing improvement.
- Multidimensional Perceived Social Support Scale (MPSS). [ Time Frame: Baseline and 4 month for Statistical Package for Social Scientists (SPSS) and only 4 month final interview for Working Alliance ] [ Designated as safety issue: No ]12 items, possible range 12-84 with higher scores indicating higher social support (i.e., better outcomes).
- Patient Reported Outcome Measurement System (PROMIS) [ Time Frame: Change from baseline to 4 month assessment ] [ Designated as safety issue: No ]Possible scores range 0-100. Higher scores represent higher pain interference. Thus lower scores represent better outcomes.
- Pain Centrality Scale [ Time Frame: 4 month assessment ] [ Designated as safety issue: No ]Possible range 10-50. Higher scores indicate higher pain centrality, i.e., worse outcomes.
|Study Start Date:||January 2013|
|Study Completion Date:||December 2013|
|Primary Completion Date:||October 2013 (Final data collection date for primary outcome measure)|
Peer-Coached Pain Self-Management
Participants (n=20) were assigned to a peer coach, who delivered self-management instruction one-on-one over a 4-month period.
Behavioral: Peer-Delivered Pain Self-Management
Patients (n=20) were assigned a peer coach to meet with for 4 months to discuss pain self-management.
This is a one-arm pilot study with a pretest/posttest design. Thus, participants' (n=20) baseline scores were compared to their final outcome assessment scores (i.e., change scores.) There was no control group.
This study is an intervention using peer coaches to deliver pain self-management instruction to patients. Peer coaches thus delivered the intervention and underwent a 3-hour training session prior to initiation of the study. Because peers served as intervention facilitators and not as recipients of the intervention, this study was not focused on peer outcomes.
Patients (n=20) attended a 2-hour didactic session led by the study nurse. Then patients were assigned a peer (2 patients per peer). Patients met with their peers for 4 months to discuss pain self-management with the guidance of a study manual. Peers were asked to contact patients a minimum of bi-weekly via telephone or in-person.
Peers reviewed each of the topic areas covered in the self-management manual. Peers reviewed a different topic each session, ask if the patient has questions, and discuss his or her personal experience with the topic being covered during that session. Modeling what the nurse care manager has done in prior studies, peers worked with patients to help them to set goals and to evaluate whether these goals are realistic. A new goal was set at each session, with the peer following up on the previous goals with the patient, whether they were accomplished, and if not, possible courses of action (e.g., modifying the goal or offering other advice to accomplish the goal). Throughout these sessions peers were encouraged to draw on their own experiences and how they personally overcame obstacles and handled setbacks and frustrations. Peers did not advise on or discuss medications or medical questions with patients.
Participating patients (n=20) were given outcome assessments at baseline and at 4-month follow-up.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01748227
|United States, Indiana|
|Richard L. Roudebush VA Medical Center, Indianapolis, IN|
|Indianapolis, Indiana, United States, 46202-2884|
|Principal Investigator:||Marianne Sassi Matthias, PhD MS BA||Richard L. Roudebush VA Medical Center, Indianapolis, IN|