Tele-Collaborative Outreach to Rural Patients with Chronic Pain:
The CORPs Trial
- Difficulty navigating complex health systems
- May not be referred for nonpharmacologic pain interventions due to lack of awareness or access
- Experience poor coordination of pain care services (both within VA and between VA and community care)
The 4-year UH3 phase will involve executing a pragmatic effectiveness trial of a tele-collaborative pain care intervention (CORPs) vs. minimally enhanced usual care (MEUC) among rural veterans with chronic musculoskeletal pain. This will take place across four geographically and operationally diverse VA Healthcare Systems.
Travis Lovejoy, PhD, M.P.H.
Benjamin Morasco, PhD
Impact and Contribution to PMC3 and Society
The CORPS study seeks to address high-impact chronic pain in veterans living in rural areas through tele-collaborative pain care intervention. The goal of the CORPs intervention from a Nurse Care Manager (NCM) perspective is to provide care coordination and pain management tools for managing persistent pain. While the program will likely not rid the Veteran of pain, the NCM will work to increase the use of complementary and integrative health (CIH) interventions in order to help the Veteran to: 1) Improve pain-related functioning; 2) Expand their personal toolkits for keeping their pain manageable; 3) Engage in activities that are the most meaningful to them.
Outcomes from this trial will help to inform tele-health pain management plans for veterans who are in remote areas, and/or locations without a VA health care center nearby.
VA Portland (Portland, OR)
VA Minneapolis (Minneapolis, MN)
VA Tennessee Valley (Nashville, TN)
VA North Texas (Dallas, TX)
Institute Providing Oversight: NCCIH
Program Officer: Peter Murray, PhD
Trial Status: UH3
Additionally, all patients randomized to CORPs are encouraged to participate in a 6-week pain education group that is held through the Cisco WebEx platform. This weekly group is led by the NCM, with topics covered in the group including: (1) the neurobiology of pain, (2) psychosocial approaches to pain management, (3) nutrition and physical activity, (4) CIH pain treatments, (5) sleep, and (6) managing negative emotions. Patients who are unable to attend a group session can receive missed information from the nurse care manager during individual follow-up appointments. The primary purpose of the pain education group is to provide patients with an overview of various approaches that are included in a multimodal pain management strategy. Patients who desire treatment in a particular domain may be referred to the appropriate service. For example, patients interested in anti-inflammatory meal planning following a group session focused on nutrition could be referred by the NCM to a dietician.
MEUC (Comparator): We have selected usual care for the comparator arm, which includes the same available pain treatments for rural veterans as the CORPs intervention. All participating sites have implemented Whole Health programs that increase access to nonpharmacologic and CIH pain treatments and regional interdisciplinary telepain programs that serve rural veterans. Because some of the regional telepain programs are relatively new and may not be known yet to referring VA clinicians, we will minimally enhance usual care by referring all patients in the MEUC arm to their local interdisciplinary telepain team after they have completed their baseline assessment.