• 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.


    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


    September 2015-September 2018


    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. 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

    Cory Lutgen, BS 
    Research Project Manager
    AAFP National Research Network
    1-800-274-2237, ext. 3174

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