Nonpharmacologic Pain Management in FQHC Primary Care Clinics (BeatPain Utah)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
Utah
-
Salt Lake City, Utah, United States, 84108
- The University of Utah Healthcare System
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Salt Lake City, Utah, United States, 84106
- Association of Utah Community Health
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Able to communicate in English or Spanish
- Age between 18-80
- Visit with an FQHC provider (in-person or via telehealth) in past 90 days
- Back pain has been an ongoing problem for at least the past 3 months, and has been a problem on at least half the days in the past 6 months
- Access to resources necessary to receive telehealth sessions (phone or 2-way video)
Exclusion Criteria:
- Currently pregnant
- Currently involved in active substance use disorder treatment (other than peer support groups, AA, etc.)
- History of spine surgery in past 6 months
- Has a condition restricting participation in physical activity (i.e., unable to ambulate independently (with or without assistive device) for at least 5 minutes.
- Reason for back pain is a fracture or non-musculoskeletal condition (i.e., spinal tumor, inflammatory disorder, etc.)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Brief Pain Teleconsult
Participants randomized to Brief Pain Teleconsult will receive the brief teleconsult intervention in Phase 1 (1-12 weeks) Responder status to the Phase 1 treatment will be examined at the 12 week assessment.
Participants determined to be non-responders will receive the Telehealth Physical Therapy intervention.
Responders receive no additional treatment.
|
The Brief Pain Teleconsult intervention includes 2 sessions provided by a licensed physical therapist over about 1 week.
The sessions focus on pain education from a biopsychosocial perspective that is designed to address negative pain appraisals and catastrophizing thoughts, providing advice to be active and engage in exercise and physical activity, and reassurance that activity is beneficial and safe.
The Telehealth Physical Therapy intervention involves weekly telehealth sessions provided over 10 weeks.
Telehealth Physical Therapy is provided by a licensed physical therapist.
Key components of the intervention include reinforcing biopsychosocial education messages and developing an exercise and physical activity program using cognitive behavioral principles such as goal setting and positive reinforcement.
Pain coping strategies including mindful breathing and progressive relaxation techniques will be included.
|
|
Experimental: Brief Pain Teleconsult plus Telehealth Physical Therapy
Participants randomized to Brief Pain Teleconsult plus Telehealth Physical Therapy will receive the brief teleconsult intervention in Phase 1 followed by the 10-week physical therapy intervention.
No additional treatment is provided after the 12 week assessment.
|
The Brief Pain Teleconsult intervention includes 2 sessions provided by a licensed physical therapist over about 1 week.
The sessions focus on pain education from a biopsychosocial perspective that is designed to address negative pain appraisals and catastrophizing thoughts, providing advice to be active and engage in exercise and physical activity, and reassurance that activity is beneficial and safe.
The Telehealth Physical Therapy intervention involves weekly telehealth sessions provided over 10 weeks.
Telehealth Physical Therapy is provided by a licensed physical therapist.
Key components of the intervention include reinforcing biopsychosocial education messages and developing an exercise and physical activity program using cognitive behavioral principles such as goal setting and positive reinforcement.
Pain coping strategies including mindful breathing and progressive relaxation techniques will be included.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
PEG-3
Time Frame: 12 weeks
|
The PEG-3 measure includes 3 items evaluating 1) pain severity, and interference of pain with 2) enjoyment and 3) general activity.
Item response options range from 0-10.
The PEG-3 score is expressed as the mean of all item scores with higher scores indicating greater pain impact
|
12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Physical Function
Time Frame: baseline, 12-, 26- and 52-weeks
|
The PROMIS short form 6b for physical function uses fixed items from the PROMIS physical function item bank to provide a T-score with population mean = 50 (sd=10).
|
baseline, 12-, 26- and 52-weeks
|
|
Sleep Disturbance
Time Frame: baseline, 12-, 26- and 52-weeks
|
The PROMIS short form 6a for sleep disturbance uses fixed items from the PROMIS sleep disturbance item bank to provide a T-score with population mean = 50 (sd=10).
|
baseline, 12-, 26- and 52-weeks
|
|
Pain Catastrophizing
Time Frame: baseline, 12-, 26- and 52-weeks
|
The PSC-6 is a short-form questionnaire evaluating an individual's negative cognitive-affective response to anticipated or actual pain
|
baseline, 12-, 26- and 52-weeks
|
|
Pain Self-Efficacy
Time Frame: baseline, 12-, 26- and 52-weeks
|
The PSEQ-4 is a short form questionnaire evaluating an individual's confidence in performing activities despite pain
|
baseline, 12-, 26- and 52-weeks
|
|
Global Impression of Change
Time Frame: baseline, 12-, 26- and 52-weeks
|
The single-item PGIC assesses participants' of change following treatment based on the question: "Since my treatment, my pain is…" with Likert scale response options ranging from (0) "very much worse" to (6) "very much improved".
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baseline, 12-, 26- and 52-weeks
|
|
opioid use
Time Frame: across 52 week follow-up
|
Prescription opioid use across the 52-week follow-up will be examined from EHR noting number of prescriptions and days of use.
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across 52 week follow-up
|
|
PEG-3
Time Frame: baseline, 26- and 52-weeks
|
The PEG-3 measure includes 3 items evaluating 1) pain severity, and interference of pain with 2) enjoyment and 3) general activity.
Item response options range from 0-10.
The PEG-3 score is expressed as the mean of all item scores with higher scores indicating greater pain impact
|
baseline, 26- and 52-weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Fritz JM, Del Fiol G, Gibson B, Wetter DW, Solis V, Bennett E, Thackeray A, Goode A, Lundberg K, Romero A, Ford I, Stevens L, Siaperas T, Morales J, Yack M, Greene T. BeatPain Utah: study protocol for a pragmatic randomised trial examining telehealth strategies to provide non-pharmacologic pain care for persons with chronic low back pain receiving care in federally qualified health centers. BMJ Open. 2022 Nov 9;12(11):e067732. doi: 10.1136/bmjopen-2022-067732.
- Fritz JM, Gibson B, Wetter DW, Del Fiol G, Solis V, Ford I, Lundberg K, Thackeray A. Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study. Implement Sci Commun. 2024 Jan 5;5(1):3. doi: 10.1186/s43058-023-00542-z.
- Fritz JM, Ford I, George SZ, Vinci de Vanegas L, Cope T, Burke CA, Goode AP. Telehealth delivery of physical therapist-led interventions for persons with chronic low back pain in underserved communities: lessons from pragmatic clinical trials. Front Pain Res (Lausanne). 2024 Apr 19;5:1324096. doi: 10.3389/fpain.2024.1324096. eCollection 2024.
- Fritz JM, Gibson B, Wetter DW, Fiol GD, Solis VH, Ford I, Lundberg K, Thackeray A. Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study. Res Sq [Preprint]. 2023 Sep 11:rs.3.rs-3267087. doi: 10.21203/rs.3.rs-3267087/v1.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- IRB_00143493
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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