Article ; Online: Mindfulness-Based Interdisciplinary Pain Management Program for Complex Polymorbid Pain in Veterans: A Randomized Controlled Trial.
Archives of physical medicine and rehabilitation
2022 Volume 103, Issue 10, Page(s) 1899–1907
Abstract: Objective: To evaluate the effects of interdisciplinary pain management on pain-related disability and opioid reduction in polymorbid pain patients with 2 or more comorbid psychiatric conditions.: Design: Two-arm randomized controlled trial testing a ...
| Abstract | Objective: To evaluate the effects of interdisciplinary pain management on pain-related disability and opioid reduction in polymorbid pain patients with 2 or more comorbid psychiatric conditions. Design: Two-arm randomized controlled trial testing a 3-week intervention with assessments at pre-treatment, post-treatment, 6-month, and 12-month follow-up. Setting: Department of Veterans Affairs medical facility. Participants: 103 military veterans (N=103) with moderate (or worse) levels of pain-related disability, depression, anxiety, and/or posttraumatic stress disorder randomly assigned to usual care (n=53) and interdisciplinary pain management (n=50). All participants reported recent persistent opioid use. Trial participants had high levels of comorbid medical and mental health conditions. Interventions: Experimental arm-a 3-week, interdisciplinary pain management program guided by a structured manual; comparison arm-usual care in a large Department of Veterans Affairs medical facility. Main outcome measures: Oswestry Disability Index (pain disability); Timeline Followback Interview and Medication Event Monitoring System (opioid use). Analysis used generalized linear mixed model with all posttreatment observations (posttreatment, 6-month follow-up, 12-month follow-up) entered simultaneously to create a single posttreatment effect. Results: Veterans with polymorbid pain randomized to the interdisciplinary pain program reported significantly greater decreases in pain-related disability compared to veterans randomized to treatment as usual (TAU) at posttreatment, 6-month, and 12-month follow-up. Aggregated mean pain disability scores (ie, a summary effect of all posttreatment observations) for the interdisciplinary pain program were -9.1 (95% CI: -14.4, -3.7, P=.001) points lower than TAU. There was no difference between groups in the proportion of participants who resumed opioid use during trial participation (32% in both arms). Conclusion: These findings offer the first evidence of short- and long-term interdisciplinary pain management efficacy in polymorbid pain patients, but more work is needed to examine how to effectively decrease opioid use in this population. |
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| MeSH term(s) | Analgesics, Opioid ; Humans ; Mindfulness ; Opioid-Related Disorders ; Pain ; Pain Management ; Veterans | |||||
| Chemical Substances | Analgesics, Opioid | |||||
| Language | English | |||||
| Publishing date | 2022-08-06 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural | |||||
| ZDB-ID | 80057-0 | |||||
| ISSN | 1532-821X ; 0003-9993 | |||||
| ISSN (online) | 1532-821X | |||||
| ISSN | 0003-9993 | |||||
| DOI | 10.1016/j.apmr.2022.06.012 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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