Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE)

VA Office of Research and Development

Status: Completed

Conditions: Chronic Pain

Treatments: Behavioral: Peer Coach Assignment

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT02380690

1410626162 (Other Identifier)

IIR 14-070

Details and patient eligibility

About

To maximize implementation potential of pain self-management in the VA, alternative delivery methods are needed to provide Veterans with education and support needed to self-manage their pain, without requiring additional resources from healthcare teams. A novel and promising approach is a peer coaching model, in which Veterans with chronic pain who are successfully managing their pain offer information, support, and mentorship to other Veterans with pain.

Full description

The investigators' goal is to test the effectiveness of a peer coaching model among Veterans. The investigators are examining feasibility for implementation alongside effectiveness, to shorten the timeline to implementation.

Aim 1 (primary aim): To compare 6-month (primary endpoint) and 9-month (sustained effects) effects of peer-supported chronic pain self-management versus controls on overall pain (intensity and function).

Hypothesis 1: Veterans in the peer support arm will experience reduced overall pain compared to controls.

Aim 2 (secondary aim): To compare 6- and 9-month effects of peer-supported chronic pain self-management versus controls on self-efficacy, social support, pain coping, patient activation, health-related quality of life, and health service utilization.

Hypothesis 2: Veterans in the peer support arm will experience greater self-efficacy, social support, pain coping, patient activation, and health-related quality of life, and lower health service utilization, compared to controls.

Aim 3 (pre-implementation aim): To explore facilitators and barriers to implementation of peer support for chronic pain, intervention costs, and fidelity to the model.

Enrollment: 215 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• have musculoskeletal pain in the low back, cervical spine, or extremities (hip, knee, or shoulder) for 3 months
• have at least moderate pain severity, defined by pain 5 on a 0 (no pain) to 10 (worst pain imaginable) scale
• indicate willingness to engage in phone or in-person contact on a regular basis with another Veteran

Exclusion criteria

• if the electronic medical record indicates a diagnosis of a psychotic disorder (e.g., International Classification of Diseases (ICD) ICD-9 codes 295-295.9 for schizophrenia)
• current substance dependence (e.g., ICD-9 codes 304-304.9)
• severe medical conditions precluding participation (e.g., New York Heart Association Class III or IV heart failure, ICD-9 codes 428-428.9 )
• if the eligibility screener given to prospective participants reveals active suicidal ideation severe hearing or speech impairment
• pending surgery for a musculoskeletal condition (e.g., back surgery)

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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215 participants in 2 patient groups

Peer Coach Assignment

Experimental group

Description:

Veteran participants will be assigned to a peer coach, who delivered self-management instruction one-on-one over a 6-month period.

Treatment:

Behavioral: Peer Coach Assignment

Control

No Intervention group

Description:

Veteran participants will attend a 2-hour class in pain "basics" and pain self-management. Veterans will aso be given a set of pamphlets related to pain self-management.