Mindfulness-based interdisciplinary pain management program for complex polymorbid pain in veterans: a randomized controlled trial
Open accessAbstract
Objective To evaluate the effects of interdisciplinary pain management on pain-related disability and opioid reduction in polymorbid pain patients with 2 or more comorbid psychiatric conditions. Design Two-arm randomized controlled trial testing a 3-week intervention with assessments at pre-treatment, post-treatment, 6-month, and 12-month follow-up. Setting Department of Veterans Affairs medical facility. Participants 103 military veterans (N=103) with moderate (or worse) levels of pain-related disability, depression, anxiety, and/or posttraumatic stress disorder randomly assigned to usual care (n=53) and interdisciplinary pain management (n=50). All participants reported recent persistent opioid use. Trial participants had high levels of comorbid medical and mental health conditions. Interventions Experimental arm-a 3-week, interdisciplinary pain management program guided by a structured manual; comparison arm-usual care in a large Department of Veterans Affairs medical facility. Main outcome measures Oswestry Disability Index (pain disability); Timeline Followback Interview and Medication Event Monitoring System (opioid use). Analysis used generalized linear mixed model with all posttreatment observations (posttreatment, 6-month follow-up, 12-month follow-up) entered simultaneously to create a single posttreatment effect. Results Veterans with polymorbid pain randomized to the interdisciplinary pain program reported significantly greater decreases in pain-related disability…
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The remaining 1 trial in patients with anxiety or stress-related disorders reported improved pain-related disability at all assessment points following the intervention.
“The remaining 1 trial 29 reported improved pain-related disability and decreased opioid use at all assessment points following the intervention.”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [29]
The remaining 1 trial reported decreased opioid use at all assessment points following the intervention.
“The remaining 1 trial 29 reported improved pain-related disability and decreased opioid use at all assessment points following the intervention.”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [29]
In the 4 trials in patients with anxiety or stress-related disorders, one trial was judged as 'low risk' and the rest were considered 'high risk' of bias.
“In terms of bias, one trial was judged as 'low risk', 29 and the rest of the trials were considered as 'high risk'.”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [29]
Among the 4 trials in patients with anxiety or stress-related disorders, one implemented a pharmacological-based intervention, one included a multi-component intervention (MCI), and the other 2 included body-based interventions.
“One trial implemented a pharmacolo gical-based intervention, 44 one included a MCI, 29 and the other 2 included body-based interventions. 33,34”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [29]
Six trials evaluated an MBI, mostly among patients with OUD.
“In total, 6 trials evaluated an MBI, mostly among pa tients with OUD, 24-30”
From The Effectiveness of Interventions for Improving Chronic Pain Symptoms Among People With Mental Illness: A Systematic Review (2024) · cites this paper as [29]
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Ma, R., Romano, E., Ashworth, M., Smith, T. O., Vancampfort, D., Scott, W., Gaughran, F., Stewart, R., & Stubbs, B. (2024) · The Journal of Pain · doi:10.1016/j.jpain.2023.11.004 · Cited by 19 · see citing works
Outcomes of Psychotherapy for Co-Morbid Pain and Substance Use Disorders: A Review of the Literature
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- Authors
- McGeary, D. D., Jaramillo, C., Eapen, B., Blount, T. H., Nabity, P. S., Moreno, J., Pugh, M. J., Houle, T. T., Potter, J. S., Young-McCaughan, S., Peterson, A. L., Villarreal, R., Brackins, N., Sikorski, Z., Johnson, T. R., Tapia, R., Reed, D., Caya, C. A., Bomer, D., Simmonds, M., & McGeary, C. A.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- South Texas Veterans Health Care System (US)
- University of California, Los Angeles (US)
- University of Utah (US)
- Corresponding author
- McGeary, Donald D.
- ORCID
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2022-10
- Volume
- 103
- Issue
- 10
- Pages
- 1899-1907
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W4292791416
- Cited by
- 3
- References
- 0
- Citations by year
- 2024: 2 · 2023: 1
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Archives of Physical Medicine and Rehabilitation (acceptedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- National Center for Complementary and Integrative Health (R01 AT008422-01)
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- multidisciplinary pain management, veterans, pain-related disability, opioid use reduction, depression, anxiety, post-traumatic stress disorder, psychiatric comorbidity, chronic pain
- MeSH terms
- Analgesics, Opioid, Humans, Opioid-Related Disorders, Pain, Veterans, Pain Management, Mindfulness
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