Testing Two Scalable, Veteran-Centric Mindfulness-Based Interventions for Chronic Musculoskeletal Pain: A Pragmatic, Multisite Trial
Diana Burgess, PhD
Institution: Minneapolis VA Health Care System, University of Minnesota
Institute Providing Oversight: Department of Defense (DoD), CDMRP
ClinicalTrials.gov Identifier: Not Yet Available
Trial Status: Currently in planning.
There is a pressing need to provide effective, non-pharmacological treatment to the vast number of Veterans with chronic musculoskeletal pain. Mindfulness-Based Interventions (MBIs) are one such approach shown to be effective for treating chronic pain and comorbid conditions (e.g., PTSD, insomnia, depression, and substance abuse). However, the predominant MBI offered in the Veterans Health Administration (VHA) and other health care systems, Mindfulness-Based Stress Reduction (MBSR), has features that pose significant barriers to widespread implementation, for patients and for VHA facilities.
Our long-term objective is to reduce chronic musculoskeletal (MSK) pain and co-morbid conditions among Veterans, through scalable, non-pharmacologic, evidence-based strategies that are “Veteran-Centric,” designed to optimize Veteran engagement, adherence and sustainability.
The MARVEL project (Mindfulness Approaches to Reduce Veterans Pain and Enhance Life) is expected to result in two approaches for delivering non-pharmacological treatment for chronic pain—in this case, Mindfulness-Based Interventions (MBIs) that incorporate mobile application technology—that will be able to reach large numbers of Veterans. The Mobile+Group MBI consists of pre-recorded modules presented by a trained mindfulness instructor that are viewed in face-to-face group settings and interspersed with discussions led by a facilitator (who is not required to be an expert in mindfulness). The Mobile MBI consists only of the same training and practice modules. Our project also focuses on adapting interventions to fit the needs of women Veterans, a priority population that is at elevated risk for chronic MSK pain and mental health comorbidities, and would be the first study to have a sample large enough to be able to examine the effects of MBIs on women with chronic pain. The MARVEL trial will be conducted at four VHA facilities across the United States, and will enroll 375 female and 375 male Veterans.