Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans
Abstract Background Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recover...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09327-5 |
| _version_ | 1797832159289933824 |
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| author | Jolie N. Haun Christopher A. Fowler Hari H. Venkatachalam Michael S. Saenger Amy C. Alman Bridget M. Smith Tali Schneider Rachel Benzinger Kevin Stroupe Dustin D. French |
| author_facet | Jolie N. Haun Christopher A. Fowler Hari H. Venkatachalam Michael S. Saenger Amy C. Alman Bridget M. Smith Tali Schneider Rachel Benzinger Kevin Stroupe Dustin D. French |
| author_sort | Jolie N. Haun |
| collection | DOAJ |
| description | Abstract Background Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act and VA’s Stepped Care Model to meet veterans’ pain management needs, the Offices of Rural Health and Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) funded an enterprise-wide initiative to implement a Step 3 integrated tele-pain program: Empower Veterans Program (EVP). EVP provides veterans with chronic pain self-care skills using a whole health driven approach to pain management. Objectives The Comprehensive Addiction and Recovery Act prompted the strategic approach to offer non-pharmacological options to meet veterans’ pain management needs. EVP, a 10-week interdisciplinary group medical appointment, leverages Acceptance and Commitment Therapy, Mindful Movement, and Whole Health to provide veterans with chronic pain self-care skills. This evaluation was conducted to describe participant characteristics, graduation, and satisfaction rates; and assess pre-post patient-reported outcomes (PRO) associated with EVP participation. Methods A sample of 639 veterans enrolled in EVP between May, 2015 and December, 2017 provided data to conduct descriptive analyses to assess participant demographics, graduation, and satisfaction rates. PRO data were analyzed using a within-participants pre-post design, and linear mixed-effects models were used to examine pre-post changes in PRO. Results Of 639 participants, 444 (69.48%) graduated EVP. Participant median program satisfaction rating was 8.41 (Interquartile Range: 8.20–9.20). Results indicate pre-post EVP improvements (Bonferroni-adjusted p < .003) in the three primary pain outcomes (intensity, interference, catastrophizing), and 12 of 17 secondary outcomes, including physical, psychological, health-related quality of life (HRQoL), acceptance, and mindfulness measures. Discussion Data suggest that EVP has significant positive outcomes in pain, psychological, physical, HRQoL, acceptance, and mindfulness measures for veterans with chronic pain through non-pharmacological means. Future evaluations of intervention dosing effect and long-term effectiveness of the program is needed. |
| first_indexed | 2024-04-09T14:03:18Z |
| format | Article |
| id | doaj.art-69bfe9488d074d78aed4789b5d67ce91 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-09T14:03:18Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-69bfe9488d074d78aed4789b5d67ce912023-05-07T11:09:36ZengBMCBMC Health Services Research1472-69632023-05-0123111310.1186/s12913-023-09327-5Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veteransJolie N. Haun0Christopher A. Fowler1Hari H. Venkatachalam2Michael S. Saenger3Amy C. Alman4Bridget M. Smith5Tali Schneider6Rachel Benzinger7Kevin Stroupe8Dustin D. French9Research and Development Service, James A. Haley Veterans’ HospitalResearch and Development Service, James A. Haley Veterans’ HospitalResearch and Development Service, James A. Haley Veterans’ HospitalAnesthesia Service Line, Atlanta Veterans Administration Health Care SystemResearch and Development Service, James A. Haley Veterans’ HospitalDepartment of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA HospitalResearch and Development Service, James A. Haley Veterans’ HospitalResearch and Development Service, James A. Haley Veterans’ HospitalDepartment of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA HospitalDepartment of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA HospitalAbstract Background Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act and VA’s Stepped Care Model to meet veterans’ pain management needs, the Offices of Rural Health and Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) funded an enterprise-wide initiative to implement a Step 3 integrated tele-pain program: Empower Veterans Program (EVP). EVP provides veterans with chronic pain self-care skills using a whole health driven approach to pain management. Objectives The Comprehensive Addiction and Recovery Act prompted the strategic approach to offer non-pharmacological options to meet veterans’ pain management needs. EVP, a 10-week interdisciplinary group medical appointment, leverages Acceptance and Commitment Therapy, Mindful Movement, and Whole Health to provide veterans with chronic pain self-care skills. This evaluation was conducted to describe participant characteristics, graduation, and satisfaction rates; and assess pre-post patient-reported outcomes (PRO) associated with EVP participation. Methods A sample of 639 veterans enrolled in EVP between May, 2015 and December, 2017 provided data to conduct descriptive analyses to assess participant demographics, graduation, and satisfaction rates. PRO data were analyzed using a within-participants pre-post design, and linear mixed-effects models were used to examine pre-post changes in PRO. Results Of 639 participants, 444 (69.48%) graduated EVP. Participant median program satisfaction rating was 8.41 (Interquartile Range: 8.20–9.20). Results indicate pre-post EVP improvements (Bonferroni-adjusted p < .003) in the three primary pain outcomes (intensity, interference, catastrophizing), and 12 of 17 secondary outcomes, including physical, psychological, health-related quality of life (HRQoL), acceptance, and mindfulness measures. Discussion Data suggest that EVP has significant positive outcomes in pain, psychological, physical, HRQoL, acceptance, and mindfulness measures for veterans with chronic pain through non-pharmacological means. Future evaluations of intervention dosing effect and long-term effectiveness of the program is needed.https://doi.org/10.1186/s12913-023-09327-5Chronic PainPain ManagementFunctional RehabilitationVeteransAcceptance and Commitment Therapy (ACT)Mindful Movement |
| spellingShingle | Jolie N. Haun Christopher A. Fowler Hari H. Venkatachalam Michael S. Saenger Amy C. Alman Bridget M. Smith Tali Schneider Rachel Benzinger Kevin Stroupe Dustin D. French Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans BMC Health Services Research Chronic Pain Pain Management Functional Rehabilitation Veterans Acceptance and Commitment Therapy (ACT) Mindful Movement |
| title | Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans |
| title_full | Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans |
| title_fullStr | Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans |
| title_full_unstemmed | Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans |
| title_short | Empower Veterans Program (EVP): a chronic pain management program demonstrates positive outcomes among veterans |
| title_sort | empower veterans program evp a chronic pain management program demonstrates positive outcomes among veterans |
| topic | Chronic Pain Pain Management Functional Rehabilitation Veterans Acceptance and Commitment Therapy (ACT) Mindful Movement |
| url | https://doi.org/10.1186/s12913-023-09327-5 |
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