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Titre : | Mindfulness-Based Interdisciplinary Pain Management Program for Complex Polymorbid Pain in Veterans: A Randomized Controlled Trial (2022) |
Auteurs : | Donald D. McGeary ; Donald D. McGeary ; Carlos Jaramillo ; Blessen C. Eapen ; Tabatha H. Blount ; Paul S. Nabity ; Jose Moreno ; Mary Jo Pugh ; Tim T. Houle ; Jennifer S. Potter ; Stacey Young-McCaughan ; Alan L. Peterson ; Robert Villarreal ; Nicole Brackins ; Zhanna Sikorski ; Tracy R. Johnson ; Rebecca Tapia ; David Reed ; Craig A. Caya ; Dillon Bomer ; Maureen Simmonds ; Cindy A. McGeary |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 103, n° 10, 2022) |
Article en page(s) : | p. 1899-1907 |
Note générale : | https://doi.org/10.1016/j.apmr.2022.06.012 |
Langues: | Français |
Descripteurs : |
HE Vinci Analgésiques morphiniques ; Douleur chronique ; Gestion de la douleur ; Polytraumatisme ; Réadaptation ; Recherche interdisciplinaire |
Résumé : | 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 compared to veterans randomized to treatment as usual (TAU) at posttreatment, 6-month, and 12-month follow-up. Aggregated mean pain disability scores (ie, a summary effect of all posttreatment observations) for the interdisciplinary pain program were -9.1 (95% CI: -14.4, -3.7, P=.001) points lower than TAU. There was no difference between groups in the proportion of participants who resumed opioid use during trial participation (32% in both arms). Conclusion These findings offer the first evidence of short- and long-term interdisciplinary pain management efficacy in polymorbid pain patients, but more work is needed to examine how to effectively decrease opioid use in this population. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999322005184 |