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Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans

BACKGROUND: Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act an...

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Autores principales: Haun, Jolie N., Fowler, Christopher A., Venkatachalam, Hari H., Saenger, Michael S., Alman, Amy C., Smith, Bridget M., Schneider, Tali, Benzinger, Rachel, Stroupe, Kevin, French, Dustin D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155644/
https://www.ncbi.nlm.nih.gov/pubmed/37138319
http://dx.doi.org/10.1186/s12913-023-09327-5
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author Haun, Jolie N.
Fowler, Christopher A.
Venkatachalam, Hari H.
Saenger, Michael S.
Alman, Amy C.
Smith, Bridget M.
Schneider, Tali
Benzinger, Rachel
Stroupe, Kevin
French, Dustin D.
author_facet Haun, Jolie N.
Fowler, Christopher A.
Venkatachalam, Hari H.
Saenger, Michael S.
Alman, Amy C.
Smith, Bridget M.
Schneider, Tali
Benzinger, Rachel
Stroupe, Kevin
French, Dustin D.
author_sort Haun, Jolie N.
collection PubMed
description BACKGROUND: Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act and VA’s Stepped Care Model to meet veterans’ pain management needs, the Offices of Rural Health and Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) funded an enterprise-wide initiative to implement a Step 3 integrated tele-pain program: Empower Veterans Program (EVP). EVP provides veterans with chronic pain self-care skills using a whole health driven approach to pain management. OBJECTIVES: The Comprehensive Addiction and Recovery Act prompted the strategic approach to offer non-pharmacological options to meet veterans’ pain management needs. EVP, a 10-week interdisciplinary group medical appointment, leverages Acceptance and Commitment Therapy, Mindful Movement, and Whole Health to provide veterans with chronic pain self-care skills. This evaluation was conducted to describe participant characteristics, graduation, and satisfaction rates; and assess pre-post patient-reported outcomes (PRO) associated with EVP participation. METHODS: A sample of 639 veterans enrolled in EVP between May, 2015 and December, 2017 provided data to conduct descriptive analyses to assess participant demographics, graduation, and satisfaction rates. PRO data were analyzed using a within-participants pre-post design, and linear mixed-effects models were used to examine pre-post changes in PRO. RESULTS: Of 639 participants, 444 (69.48%) graduated EVP. Participant median program satisfaction rating was 8.41 (Interquartile Range: 8.20–9.20). Results indicate pre-post EVP improvements (Bonferroni-adjusted p < .003) in the three primary pain outcomes (intensity, interference, catastrophizing), and 12 of 17 secondary outcomes, including physical, psychological, health-related quality of life (HRQoL), acceptance, and mindfulness measures. DISCUSSION: Data suggest that EVP has significant positive outcomes in pain, psychological, physical, HRQoL, acceptance, and mindfulness measures for veterans with chronic pain through non-pharmacological means. Future evaluations of intervention dosing effect and long-term effectiveness of the program is needed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09327-5.
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spelling pubmed-101556442023-05-05 Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans Haun, Jolie N. Fowler, Christopher A. Venkatachalam, Hari H. Saenger, Michael S. Alman, Amy C. Smith, Bridget M. Schneider, Tali Benzinger, Rachel Stroupe, Kevin French, Dustin D. BMC Health Serv Res Research BACKGROUND: Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act and VA’s Stepped Care Model to meet veterans’ pain management needs, the Offices of Rural Health and Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) funded an enterprise-wide initiative to implement a Step 3 integrated tele-pain program: Empower Veterans Program (EVP). EVP provides veterans with chronic pain self-care skills using a whole health driven approach to pain management. OBJECTIVES: The Comprehensive Addiction and Recovery Act prompted the strategic approach to offer non-pharmacological options to meet veterans’ pain management needs. EVP, a 10-week interdisciplinary group medical appointment, leverages Acceptance and Commitment Therapy, Mindful Movement, and Whole Health to provide veterans with chronic pain self-care skills. This evaluation was conducted to describe participant characteristics, graduation, and satisfaction rates; and assess pre-post patient-reported outcomes (PRO) associated with EVP participation. METHODS: A sample of 639 veterans enrolled in EVP between May, 2015 and December, 2017 provided data to conduct descriptive analyses to assess participant demographics, graduation, and satisfaction rates. PRO data were analyzed using a within-participants pre-post design, and linear mixed-effects models were used to examine pre-post changes in PRO. RESULTS: Of 639 participants, 444 (69.48%) graduated EVP. Participant median program satisfaction rating was 8.41 (Interquartile Range: 8.20–9.20). Results indicate pre-post EVP improvements (Bonferroni-adjusted p < .003) in the three primary pain outcomes (intensity, interference, catastrophizing), and 12 of 17 secondary outcomes, including physical, psychological, health-related quality of life (HRQoL), acceptance, and mindfulness measures. DISCUSSION: Data suggest that EVP has significant positive outcomes in pain, psychological, physical, HRQoL, acceptance, and mindfulness measures for veterans with chronic pain through non-pharmacological means. Future evaluations of intervention dosing effect and long-term effectiveness of the program is needed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09327-5. BioMed Central 2023-05-03 /pmc/articles/PMC10155644/ /pubmed/37138319 http://dx.doi.org/10.1186/s12913-023-09327-5 Text en © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Haun, Jolie N.
Fowler, Christopher A.
Venkatachalam, Hari H.
Saenger, Michael S.
Alman, Amy C.
Smith, Bridget M.
Schneider, Tali
Benzinger, Rachel
Stroupe, Kevin
French, Dustin D.
Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans
title Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans
title_full Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans
title_fullStr Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans
title_full_unstemmed Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans
title_short Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans
title_sort empower veterans program (evp): a chronic pain management program demonstrates positive outcomes among veterans
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155644/
https://www.ncbi.nlm.nih.gov/pubmed/37138319
http://dx.doi.org/10.1186/s12913-023-09327-5
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