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Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial

BACKGROUND: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging developme...

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Autores principales: George, Steven Z, Coffman, Cynthia J, Allen, Kelli D, Lentz, Trevor A, Choate, Ashley, Goode, Adam P, Simon, Corey B, Grubber, Janet M, King, Heather, Cook, Chad E, Keefe, Francis J, Ballengee, Lindsay A, Naylor, Jennifer, Brothers, Joseph Leo, Stanwyck, Catherine, Alkon, Aviel, Hastings, Susan N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734660/
https://www.ncbi.nlm.nih.gov/pubmed/33313728
http://dx.doi.org/10.1093/pm/pnaa348
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author George, Steven Z
Coffman, Cynthia J
Allen, Kelli D
Lentz, Trevor A
Choate, Ashley
Goode, Adam P
Simon, Corey B
Grubber, Janet M
King, Heather
Cook, Chad E
Keefe, Francis J
Ballengee, Lindsay A
Naylor, Jennifer
Brothers, Joseph Leo
Stanwyck, Catherine
Alkon, Aviel
Hastings, Susan N
author_facet George, Steven Z
Coffman, Cynthia J
Allen, Kelli D
Lentz, Trevor A
Choate, Ashley
Goode, Adam P
Simon, Corey B
Grubber, Janet M
King, Heather
Cook, Chad E
Keefe, Francis J
Ballengee, Lindsay A
Naylor, Jennifer
Brothers, Joseph Leo
Stanwyck, Catherine
Alkon, Aviel
Hastings, Susan N
author_sort George, Steven Z
collection PubMed
description BACKGROUND: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging development; however, what constitutes best practice for nonpharmacologic management of low back pain (LBP) is largely unknown. DESIGN: The Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) trial is an embedded pragmatic cluster-randomized trial that will examine the effectiveness of two different care pathways for LBP. Sixteen primary care clinics will be randomized 1:1 to receive training in delivery of 1) an integrated sequenced-care pathway or 2) a coordinated pain navigator pathway. Primary outcomes are pain interference and physical function (Patient-Reported Outcomes Measurement Information System Short Form [PROMIS-SF]) collected in the electronic health record at 3 months (n=1,680). A subset of veteran participants (n=848) have consented to complete additional surveys at baseline and at 3, 6, and 12 months for supplementary pain and other measures. SUMMARY: AIM-Back care pathways will be tested for effectiveness, and treatment heterogeneity will be investigated to identify which veterans may respond best to a given pathway. Health care utilization patterns (including opioid use) will also be compared between care pathways. Therefore, the AIM-Back trial will provide important information that can inform the future delivery of nonpharmacologic treatment of LBP.
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spelling pubmed-77346602020-12-17 Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial George, Steven Z Coffman, Cynthia J Allen, Kelli D Lentz, Trevor A Choate, Ashley Goode, Adam P Simon, Corey B Grubber, Janet M King, Heather Cook, Chad E Keefe, Francis J Ballengee, Lindsay A Naylor, Jennifer Brothers, Joseph Leo Stanwyck, Catherine Alkon, Aviel Hastings, Susan N Pain Med EDITORIALS BACKGROUND: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging development; however, what constitutes best practice for nonpharmacologic management of low back pain (LBP) is largely unknown. DESIGN: The Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) trial is an embedded pragmatic cluster-randomized trial that will examine the effectiveness of two different care pathways for LBP. Sixteen primary care clinics will be randomized 1:1 to receive training in delivery of 1) an integrated sequenced-care pathway or 2) a coordinated pain navigator pathway. Primary outcomes are pain interference and physical function (Patient-Reported Outcomes Measurement Information System Short Form [PROMIS-SF]) collected in the electronic health record at 3 months (n=1,680). A subset of veteran participants (n=848) have consented to complete additional surveys at baseline and at 3, 6, and 12 months for supplementary pain and other measures. SUMMARY: AIM-Back care pathways will be tested for effectiveness, and treatment heterogeneity will be investigated to identify which veterans may respond best to a given pathway. Health care utilization patterns (including opioid use) will also be compared between care pathways. Therefore, the AIM-Back trial will provide important information that can inform the future delivery of nonpharmacologic treatment of LBP. Oxford University Press 2020-12-10 /pmc/articles/PMC7734660/ /pubmed/33313728 http://dx.doi.org/10.1093/pm/pnaa348 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle EDITORIALS
George, Steven Z
Coffman, Cynthia J
Allen, Kelli D
Lentz, Trevor A
Choate, Ashley
Goode, Adam P
Simon, Corey B
Grubber, Janet M
King, Heather
Cook, Chad E
Keefe, Francis J
Ballengee, Lindsay A
Naylor, Jennifer
Brothers, Joseph Leo
Stanwyck, Catherine
Alkon, Aviel
Hastings, Susan N
Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial
title Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial
title_full Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial
title_fullStr Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial
title_full_unstemmed Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial
title_short Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial
title_sort improving veteran access to integrated management of back pain (aim-back): protocol for an embedded pragmatic cluster-randomized trial
topic EDITORIALS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734660/
https://www.ncbi.nlm.nih.gov/pubmed/33313728
http://dx.doi.org/10.1093/pm/pnaa348
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