Living with Pain

Study Description and Methods

An estimated 100 million Americans live with chronic pain and many of them visit their family physician for relief. Managing these patients can be challenging. Physicians and patients often feel they have few alternatives to a pharmacological treatment focus; new or additional strategies are needed to help family physicians address chronic pain with their patients.

This study will test a new approach (i.e., photo elicitation intervention combined with access to online community support and a chronic pain guideline) in helping patients live with chronic pain. By doing so, the study team proposes to use a multifaceted intervention to move the care focus from pain intensity to improving function.

Specific Aims and Objectives

Primary objective:

To test if a photo elicitation intervention combined with access to online community support and a chronic pain guideline can improve a 3-item measure of chronic pain [the PEG score: Pain intensity (P), Enjoyment of Life (E), and General Activity (G)] (Krebs et al. 2009) and a patient-identified area of function, compared to a group who receive the chronic pain guideline and usual care.

Secondary objectives:

1. Assess the effectiveness of this intervention to improve patients’ self-efficacy to self-manage pain; 2. Assess the effectiveness of the intervention to improve patients’ pain acceptance. Quantitatively and qualitatively assess the effects of the intervention on the patient-centeredness of the clinician-patient relationship.

We hypothesize that participation in this intervention will improve the patient-centeredness of the clinician patient relationship, improve the patient’s self-efficacy to manage chronic pain, and improve the patient’s acceptance of their pain. We further hypothesize that patient-centeredness, pain self-efficacy, and pain acceptance will mediate pain function, both in general (measured by the G of the PEG) and in their own patient-nominated specific area of function. We will explore whether the intervention also reduces patient-reported pain intensity (measured by the P of the PEG) as we hypothesize that this will occur with increased pain acceptance and self-efficacy.

Study Overview

Practices in this study were randomly assigned to one of two groups: 1) the photo elicitation combined with access to an online community support via Facebook and a chronic pain guideline or 2) chronic pain guideline plus usual care.

References

Krebs, E. E., Lorenz, K. A., Bair, M. J., Damush, T. M., Wu, J., Sutherland, J. M., … Kroenke, K. (2009).Development and Initial Validation of the PEG, a Three-item Scale Assessing Pain Intensity and Interference. Journal of General Internal Medicine, 24(6), 733–738. http://doi.org/10.1007/s11606-009-0981-1

Timeline

September 2015-September 2018

Status

Recruiting Patients

Key Findings and Publications

Rolbiecki, A.J., Crenshaw, B., Mehr, D., Ordway, J., Vinson, D. (2016, Nov) Pictures Say 1,000 Words: A Patient Centered Intervention for Chronic Pain.(1 MB PDF) Poster Session at North American Primary Care Research Group (NAPCRG) Annual Meeting Colorado Springs, CO.

Contact Information

For additional information about this study, please contact:

Joseph LeMaster MD, MPH
Principal Investigator
AAFP National Research Network

Ben Crenshaw MD
Principal Investigator
University of Missouri SOM
Family and Community Medicine

Robin Liston MPH
Sr. Research Project Manager
AAFP National Research Network
(800) 274-2237, ext. 3175
rliston2@kumc.edu

Emily Bullard MPH
Research Project Manager
AAFP National Research Network
(800) 274-2237, ext. 3174
ebullard@aafp.org


This study is funded by grants from the Agency for Healthcare Research and Quality (AHRQ)