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Peer Support for Self-Management of Chronic Pain: the Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) Trial.

Abstract：

BACKGROUND:Pain self-management is an effective, evidence-based treatment for chronic pain. Peer support, in which patients serve as coaches for other patients, has been effective in other chronic conditions and is a potentially promising approach to implementing pain self-management programs using fewer clinical resources. OBJECTIVE:To test a peer coach-delivered pain self-management program for chronic pain. DESIGN:Randomized controlled trial. PARTICIPANTS:Veterans with chronic musculoskeletal pain. INTERVENTION:Intervention patients were assigned a trained peer coach for 6 months. Coaches, who were volunteers, were asked to contact their assigned patients, either by phone or in person, twice per month. Coaches and patients were given an intervention manual to guide sessions. The control group was offered a 2-hour pain self-management class. MAIN MEASURES:The primary outcome was total pain, assessed by the Brief Pain Inventory (BPI). Secondary outcomes were anxiety, depression, pain catastrophizing, self-efficacy, social support, patient activation, health-related quality of life, and healthcare utilization. Outcomes were measured at baseline, 6 months, and 9 months. KEY RESULTS:Two hundred fifteen patients enrolled (120 intervention, 95 control). Adherence to intervention protocol was low, with only 13% of patients reporting having at least the recommended 12 peer coach meetings over the 6-month intervention. BPI total decreased from baseline to 6 months and baseline to 9 months in both groups. At 9 months, this change was statistically significant (intervention, - 0.40, p = 0.018; control, - 0.47, p = 0.006). There was not a statistically significant difference between groups on BPI at either time point. No secondary outcomes improved significantly in either group after adjusting for multiple comparisons. CONCLUSIONS:Patients randomized to peer support did not differ from control patients on primary and secondary outcomes. Other peer support models that do not rely on volunteers might be more effective. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT02380690.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Matthias MS,Bair MJ,Ofner S,Heisler M,Kukla M,McGuire AB,Adams J,Kempf C,Pierce E,Menen T,McCalley S,Johnson NL,Daggy J

doi

10.1007/s11606-020-06007-6

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

3525-3533

issue

eissn

0884-8734

issn

1525-1497

pii

10.1007/s11606-020-06007-6

journal_volume

pub_type

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Peer Support for Self-Management of Chronic Pain: the Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) Trial.