Pain Management Teams using Whole Health to Optimize Function and Safety in Veterans (TEAMWORK trial)
Project Summary
This pragmatic randomized controlled trial aims to test two different approaches to chronic pain management for veterans with chronic pain prescribed opioids. The approaches consist of two active interventions: (1) pain management teams including the ability to manage medication and provide behavioral rehabilitation treatments, and (2) these same pain management teams plus Whole Health Coaching. The two active interventions will be compared to one another. The research team will also provide implementation support to pain management teams in offering evidence-based pain care and evaluate the impact of that support.
Co-Principal Investigators
Sara Edmond, PhD
Karen Seal, MD, MPH
William Becker, MD
Impact and Contribution to PMC and Society
There is a critical need to identify and support the implementation of interdisciplinary pain management teams that are able to help patients with chronic pain and opioid safety concerns. This project will evaluate the added benefit of Whole Health Coaching to pain management teams while also evaluating the best way to provide implementation support to those teams.
Details
Institutions: VA Connecticut Health Care System, San Francisco VA Health Care System
Sponsor: Department of Veterans Affairs, Health Services Research (HSR)
For an overview, visit clinicaltraials.gov (identifier pending)
For results go to publications and search for TEAMWORK trial.
Project Narrative
The problems of high-impact chronic pain and harms related to opioid use continue to be major public health concerns. To address this, the 2016 Comprehensive Addiction and Recovery Act (CARA) mandated that each VHA facility designate interdisciplinary pain management teams (PMTs) which includes providers with expertise in pain, addiction, behavioral approaches, and rehabilitation therapies. More work is needed to understand how to best build and maintain effective PMTs. One goal of this study is to provide implementation support to PMTs and to evaluate the types of implementation support provided.
Whole Health Coaching (WHC) is a treatment offered at the VA by certified health and wellness coaches. WHC involves conducting a personal health inventory and creating a personal health plan which includes setting health-related goals. Coaches support patients in pursuing, refining, and tracking goals and examining barriers and ambivalence where appropriate.
In this study, we will test the added benefit of Whole Health Coaches (WHCs) for Veterans with chroinic pain and opioid safety concerns. The pupose of this trial is to compare the effectiveness of treatment with a usual care pain management team (PMT-UC) vs. treatment enhances with Whole Health coaching (PMT-WHC). We will randomize 432 patients, to compare PMT-UC vs. PMT-WHC. We will measure pain outcomes and opioid safety.
