TY - JOUR
T1 - Randomized Trial of a Low-Literacy Chronic Pain Self-Management Program
T2 - Analysis of Secondary Pain and Psychological Outcome Measures
AU - Turner, Barbara J.
AU - Liang, Yuanyuan
AU - Rodriguez, Natalia
AU - Bobadilla, Raudel
AU - Simmonds, Maureen J.
AU - Yin, Zenong
N1 - Funding Information:
Supported by a methods research award from the Patient-Centered Outcomes Research Institute (grant ME-13035729) and the University of Texas System 2015 Patient Safety Research Award (OGC grant 162293). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2018 the American Pain Society
PY - 2018/12
Y1 - 2018/12
N2 - Based on input of rural, largely Hispanic persons with chronic pain, a low-literacy, 6-month self-management program was developed, drawing on elements of existing pain toolkits. In a randomized trial, low-income, primarily Hispanic patients with chronic pain received the program in 6 sessions of 1-on-1 meetings with a trained health educator in clinic or in 8 group lectures by experts in the community. Intention-to-treat analyses in linear mixed-effects models were conducted for 5 secondary outcomes at 6 months, including Brief Pain Inventory pain severity and interference, Patient Health Questionnaire-9, 12-Item Short-Form Survey Mental Component Summary, and Tampa Scale for Kinesiophobia-11. A total of 111 participants were randomized (15.9% of 700 initially eligible from 3 clinics), and 67 (60.4%) completed 6-month measures. Among completers, the clinic arm improved on 4 measures and community arm on 3 measures (all P <.05). Effect sizes were small to moderate (.41–.52). In intention-to-treat analyses, both arms improved on 4 of 5 measures (all P ≤.001) versus baseline, with clinically significant changes in Brief Pain Inventory pain severity and interference. Improvement in multiple outcomes after this chronic pain self-management program for low-income patients warrants further study. Perspective: In an evaluation of a low-literacy, 6-month chronic pain self-management program, similar improvements were observed among primarily Hispanic participants whether the intervention was delivered by a health educator or in groups with lectures from experts.
AB - Based on input of rural, largely Hispanic persons with chronic pain, a low-literacy, 6-month self-management program was developed, drawing on elements of existing pain toolkits. In a randomized trial, low-income, primarily Hispanic patients with chronic pain received the program in 6 sessions of 1-on-1 meetings with a trained health educator in clinic or in 8 group lectures by experts in the community. Intention-to-treat analyses in linear mixed-effects models were conducted for 5 secondary outcomes at 6 months, including Brief Pain Inventory pain severity and interference, Patient Health Questionnaire-9, 12-Item Short-Form Survey Mental Component Summary, and Tampa Scale for Kinesiophobia-11. A total of 111 participants were randomized (15.9% of 700 initially eligible from 3 clinics), and 67 (60.4%) completed 6-month measures. Among completers, the clinic arm improved on 4 measures and community arm on 3 measures (all P <.05). Effect sizes were small to moderate (.41–.52). In intention-to-treat analyses, both arms improved on 4 of 5 measures (all P ≤.001) versus baseline, with clinically significant changes in Brief Pain Inventory pain severity and interference. Improvement in multiple outcomes after this chronic pain self-management program for low-income patients warrants further study. Perspective: In an evaluation of a low-literacy, 6-month chronic pain self-management program, similar improvements were observed among primarily Hispanic participants whether the intervention was delivered by a health educator or in groups with lectures from experts.
KW - Chronic pain
KW - Hispanic
KW - low-income populations
KW - patient engagement
KW - self-management
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U2 - 10.1016/j.jpain.2018.06.010
DO - 10.1016/j.jpain.2018.06.010
M3 - Article
C2 - 30012494
AN - SCOPUS:85054502557
VL - 19
SP - 1471
EP - 1479
JO - Journal of Pain
JF - Journal of Pain
SN - 1526-5900
IS - 12
ER -