Evaluation of a non‐pharmacological interdisciplinary pain rehabilitation and functional restoration program for chronic pain in veterans
Open accessAbstract
Objective: To conduct a quality improvement evaluation of the Empower Veterans Program (EVP), an interdisciplinary pain rehabilitation/functional restoration program option for functional restoration for high‐impact chronic pain, offered in a large metro‐area Veterans Health Administration (VHA) system. Data Sources: VHA Corporate Data Warehouse electronic medical record data for patients treated by EVP between 2015 and 2019. Evaluation Design: This retrospective design first compared EVP patients considered engaged or not engaged in completing treatment in terms of demographic characteristics and post‐treatment changes in clinical measures related to opioid use and mental health. We then compared mortality risk between matched groups of treated and untreated patients with chronic pain and concurrent opioid prescriptions using propensity score matching and Cox proportional hazards methods. “Treated” in the matched groups was defined as any level of EVP participation (i.e., both engaged and not engaged). Data Collection/Extraction Methods: We first identified 1053 EVP patients with 1 year of pre‐and post‐treatment follow‐time and determined their engagement level. From those with chronic pain and prescription opioids, we matched 237 EVP patients to 375 untreated patients. Principal Findings: Engaged patients (57.4% of treated patients), were somewhat older than the non‐engaged (mean age 57.1 vs. 53.7, Cohen's D = 0.30), and achieved lower mean PHQ9 depression scores in the post‐treatment year (9.2 vs. 10.6, Cohen's D = 0.20). Participation in EVP was associated with a 65% lower mortality risk among Veterans with chronic pain and opioid use when compared to the untreated patients: (HR: 0.35, 95% CI: 0.17, 0.75). Conclusions: EVP was associated with a large reduction in mortality risk for Veterans with both chronic pain and opioid use. This result could inform the decision process in a VA station or region when considering providing or expanding access to an interdisciplinary rehabilitation/functional restoration program for chronic pain.
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This paper offers a PiPT framework for mindful movement that is evidence-based, theory-driven, and has real-world implementation with positive outcomes for an integrated approach to interdisciplinary pain care.
“This paper offers a PiPT framework for mindful movement that is evidence-based, theory-driven, and has real-world implementation with positive outcomes for an integrated approach to interdisciplinary pain care.63,65,68”
From Remotely Delivered Psychologically Informed Mindful Movement Physical Therapy for Pain Care: A Framework for Operationalization (2023) · cites this paper as [68]
The Introduction describes an evidence-informed interdisciplinary program based on biopsychosocial models, and the Conclusions and Recommendations describe its mindful-movement component. The Results report positive outcomes for the program as a whole. Our copy does not present a PiPT framework or establish outcomes specifically for mindful movement; page numbers were not provided. (LLM, conf=0.85)
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Who Benefits from Opioids? A Best Practices Approach
Noe, C. E., Helm, S., & Racz, G. B. (2025) · Springer eBooks · doi:10.1007/978-3-031-86057-7_27
- Authors
- Ward, R., Rauch, S. A. M., Axon, R. N., & Saenger, M. S.
- Affiliations
- Medical University of South Carolina (US)
- Emory University (US)
- Corresponding author
- Ward, Ralph
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2022-10-10
- Volume
- 58
- Issue
- 2
- Pages
- 365-374
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- PMC
- PMC10012215
- OpenAlex
- W4294989825
- Cited by
- 9
- References
- 28
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 2 · 2022: 1
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- public-domain
- onlinelibrary.wiley.com/termsAndConditions#vor (vor)
- Locations
- Health Services Research (publishedVersion)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- chronic pain, veterans, interdisciplinary pain rehabilitation, functional restoration, prescription opioid use, mortality risk, depression, treatment engagement, non-pharmacological pain management, Veterans Health Administration
- MeSH terms
- Analgesics, Opioid, Humans, Middle Aged, Opioid-Related Disorders, Retrospective Studies, United States, United States Department of Veterans Affairs, Veterans, Chronic Pain
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