Whole health options and pain education (WHOPE): A pragmatic trial comparing whole health team vs primary care group education to promote nonpharmacological strategies to improve pain, functioning, and quality of life in veterans-rationale, methods, and implementation

Karen H. Seal, William C. Becker, Jennifer L. Murphy, Natalie Purcell, Lauren M. Denneson, Benjamin J. Morasco, Aaron M. Martin, Kavitha Reddy, Theresa van Iseghem, Erin E. Krebs, Jacob M. Painter, Hildi Hagedorn, Jeffrey M. Pyne, John Hixon, Shira Maguen, Thomas C. Neylan, Brian Borsari, Beth DeRonne, Carolyn Gibson, Marianne S. MatthiasJoseph W. Frank, Akshaya Krishnaswamy, Yongmei Li, Daniel Bertenthal, Allan Chan, Alejandro Nunez, Nicole McCamish

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background. The Whole Health model of the U.S. Department of Veterans Affairs (VA) emphasizes holistic self-care and multimodal approaches to improve pain, functioning, and quality of life. wHOPE (Whole Health Options and Pain Education) seeks to be the first multisite pragmatic trial to establish evidence for the VA Whole Health model for chronic pain care. Design. wHOPE is a pragmatic randomized controlled trial comparing a Whole Health Team (WHT) approach to Primary Care Group Education (PC-GE); both will be compared to Usual VA Primary Care (UPC). The WHT consists of a medical provider, a complementary and integrative health (CIH) provider, and a Whole Health coach, who collaborate with VA patients to create a Personalized Health Plan emphasizing CIH approaches to chronic pain management. The active comparator, PC-GE, is adapted group cognitive behavioral therapy for chronic pain. The first aim is to test whether the WHT approach is superior to PC-GE and whether both are superior to UPC in decreasing pain interference in functioning in 750 veterans with moderate to severe chronic pain (primary outcome). Secondary outcomes include changes in pain severity, quality of life, mental health symptoms, and use of nonpharmacological and pharmacological therapies for pain. Outcomes will be collected from the VA electronic health record and patient-reported data over 12 months of follow-up. Aim 2 consists of an implementation-focused process evaluation and budget impact analysis. Summary. This trial is part of the Pain Management Collaboratory, which seeks to create national-level infrastructure to support evidence-based nonpharmacological pain management approaches for veterans and military service personnel.

Original languageEnglish (US)
Pages (from-to)S91-S99
JournalPain Medicine (United States)
Volume21
DOIs
StatePublished - 2020

Bibliographical note

Funding Information:
Funding sources: This work is supported by the National Institutes of Health (NIH) through cooperative agreement U24AT009769 and cooperative agreement UG3AT009765/UH3AT009765 from the National Center for Complementary and Integrative Health (NCCIH).

Funding Information:
This work is supported by the National Institutes of Health (NIH) through cooperative agreement U24AT009769 and cooperative agreement UG3AT009765/UH3AT009765 from the National Center for Complementary and Integrative Health (NCCIH). This manuscript is a product of the NIH-DOD-VA Pain Management Collaboratory (PMC). For more information on the PMC, please visit https://painmanagementcollaboratory.org/.

Funding Information:
Supplement sponsorship: This article appears as part of the supplement entitled “NIH-DOD-VA Pain Management Collaboratory (PMC)”. This supplement was made possible by Grant Number U24 AT009769 from the National Center for Complementary and Integrative Health (NCCIH), and the Office of Behavioral and Social Sciences Research (OBSSR). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCIH, OBSSR, and the National Institutes of Health.

Publisher Copyright:
© 2020 Oxford University Press. All rights reserved.

Keywords

  • Chronic PainVeterans
  • Cognitive behavior therapy
  • Complementary and integrative health
  • Pragmatic trial
  • Primary care

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

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