Engaging Veterans Seeking Service-Connection Payments in Pain Treatment (PragmaticSBIRT)
- Study HIC#:2000022664
- Last Updated:07/15/2021
Veterans seeking compensation for musculoskeletal (MSD) conditions often develop chronic pain and are at high risk for substance misuse. The Investigators propose to test the effectiveness and cost-effectiveness of Screening, Brief Intervention and Referral to Treatment for Pain Management (SBIRT-PM), designed to reduce pain and reduce risky substance use, in part by helping Veterans get comprehensive pain treatment. The study will involve a 2-year period to arrange for clinicians at a single site to counsel Veterans throughout New England by phone with SBIRT-PM as part of a clinical trial, and a 4-year period to conduct the trial and disseminate its findings.
- Age18 years - 100 years
- Start Date01/15/2019
- End Date02/28/2024
Trial Purpose and Description
Yale’s engagement in this research is related to funding only. The study is only conducted at the VA sites and all individuals working on the study are doing so in their capability as VA employees. This proposal involves a pragmatic multi-site clinical trial of an early intervention with this at-risk population of Veterans: Screening, Brief Intervention and Referral to Treatment for Pain Management (SBIRT-PM). SBIRT-PM aims to engage Veterans applying for compensation with pain conditions in multi-modal non-pharmacological pain care and to motivate those who misuse substances to change this problematic behavior.
SBIRT-PM will be delivered centrally by telephone throughout the New England VA Healthcare System s (VISN1) eight medical centers using a hub-and-spoke network implementation strategy guided by a Relational Coordination Framework. Hub-based SBIRT-PM clinicians will coordinate Veterans engagement in non-pharmacological pain services through interactions with the extant spoke site personnel who refer Veterans to pain and/or substance abuse treatment. Drawing from each of the eight medical centers, we will randomize 1200 Veterans applying for compensation related to MSD to either: 1) SBIRT-PM, a telephone-based initial session followed by up to three calls in a 12-week period to support Veterans engagement in non-pharmacological pain care; or 2) usual care (UC) at each site for Veterans seeking compensation evaluations. Outcome assessment will occur at 12 and 36-week follow-ups.
- Post-9/11 Veteran applying for MSD-related compensation, as ascertained from filed claim,
- Reports pain ≥4 on the pain Numerical Rating Scale (threshold for moderately severe pain);
- Availability of a landline or cellular telephone for SBIRT-PM.
- Reports inability to participate during the study enrollment call
- Received three or more non-pharmacological pain treatment modalities (as previously categorized within the last 12 weeks from VA.