Pain, Substance Use Disorders
Conditions
Brief summary
Veterans seeking compensation for musculoskeletal (MSD) conditions often develop chronic pain and are at high risk for substance misuse. The Investigators propose to test the effectiveness and cost-effectiveness of Screening, Brief Intervention and Referral to Treatment for Pain Management (SBIRT-PM), designed to reduce pain and reduce risky substance use, in part by helping Veterans get comprehensive pain treatment. The study will involve clinicians at a single site contacting Veterans throughout New England by phone to deliver SBIRT-PM counseling in a pragmatic, randomized, clinical trial.
Detailed description
In 2015 alone, 97,223 new Veterans under age 35 began receiving compensation for injuries related to their military service. In total, there are 559,999 post-9/11 Veterans being compensated for back or neck conditions, and a partially overlapping 596,250 for limitation of flexion in joints. Veterans seeking compensation for musculoskeletal conditions often develop chronic pain and are at high risk for substance misuse. Early intervention is needed to arrest worsening pain and risky substance use, particularly among post-9/11 Veterans for whom engagement in non-pharmacological pain treatment has the potential to improve their overall quality of life and spare them the complications of opioid treatments. The service-connection application is an ideal point-of contact for initiating early intervention treatments for these at-risk Veterans. The Investigators propose to test the effectiveness and cost-effectiveness of Screening, Brief Intervention and Referral to Treatment for Pain Management (SBIRT-PM), designed to reduce pain and risky substance use. In brief, the counselor explains that treating both physical and psychological aspects of pain leads to the best outcomes, outlines what VA (and non-VA if preferred) services are available to Veterans, explains that substances are sometimes used for pain relief, and segues into traditional SBIRT. SBIRT-PM's efficacy is supported by a completed clinical trial of 101 Veterans applying for service-connection for MSD, and by studies showing the efficacy of SBIRT for people with risky substance use and of Motivational Interviewing for engagement in non-pharmacological pain care. During a two-years pilot study, the study team prepared SBIRT-PM for implementation by establishing communication (Relational Coordination is the theoretical framework) between the "hub" where the SBIRT-PM clinician is sited and the "spoke" sites, establishing study related procedures, and piloting the intervention at each of the eight VA medical centers in New England. In this full clinical trial, investigators will randomize 1100 Veterans applying for compensation related to MSD to either SBIRT-PM or Usual Care (UC) across eight VA medical centers in New England. Outcome assessment by phone will occur at 12 and 36-week follow-ups, and will be corroborated with other sources of information ---the electronic health record. Investigators hypothesize that, compared to Usual Care, SBIRT-PM will be more effective and cost-effective in improving Veterans' pain and substance use. Investigators further hypothesize that a mediator of these improvements will be use of non-pharmacological services, as extracted from VA records from structured data fields and from narrative text in the medical record using an innovative natural language processing algorithm. Screening and referral to treatment at service-connection examinations can transform a widely-used point of entry to VA into a health promoting encounter.
Interventions
BEHAVIORALSBIRT-PM
SBIRT-PM involves an initial telephone-delivered session followed by up to three calls to Veterans in a 12-week period to support Veteran engagement in multi-modal non-pharmacological pain care and to motivate those who misuse substances to change this problematic behavior. SBIRT-PM also includes coordination between the SBIRT-PM clinicians and the PACT nurse case manager after the initial session to support these patient outcomes.
Sponsors
Yale University
National Center for Complementary and Integrative Health (NCCIH)
National Institute on Drug Abuse (NIDA)
US Department of Veterans Affairs
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
Research Assistants collect data from participant interviews at 12 and 36 weeks follow-up. They will be blind to randomization condition.
Intervention model description
Participants receive either usual care or study intervention
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Post-9/11 Veteran applying for MSD-related compensation, as ascertained from filed claim, * Reports a score of ≥4 (threshold for moderately severe pain) on the BPI's Pain Severity subscale (average of four pain intensity items); * Availability of a landline or cellular telephone for SBIRT-PM.
Exclusion criteria
* Reports inability to participate during the study enrollment call * Received three or more non-pharmacological pain treatment modalities within the last 12 weeks from VA. * Participating in another PMC3 study as evidenced by a research protocol alert for that study at the time the study invitation letter is mailed.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain Intensity Subscale of Brief Pain Inventory | 36 weeks | Pain Intensity subscale of the Brief Pain Inventory uses a 0-10 numeric rating scale (0=no pain to 10=pain as bad as you can imagine) to measure four pain severity/intensity items: "worst" pain in the last 24 hours, "least" pain in the last 24 hours, "average" pain, and pain right "now". The pain intensity subscale is scored as a composite of the four pain items (mean intensity score). |
| Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | 36 weeks | Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed to detect and manage substance use and related problems. Substance use will be measured over the last 3 months using Version 3.1.After a screening question focusing on substances ever used, the ASSIST consists of 7 questions about use of and consequences of use of each of 11 classes of substances over the preceding three months (including nicotine, THC and medical THC). Scores are generated for each substance that are mapped to a three-point ordinal score of severity: "no need for treatment", "need for a brief intervention" and "need for an intensive intervention". The number of problem substances are defined as the number of substances above the "no intervention" threshold \*only participants who had a problem substance reported at baseline were analyzed for this outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cost-Effectiveness Ratios (ICERs) | 36 weeks | The Incremental Cost-Effectiveness Ratio (ICER) was determined as the ratio of the difference in cost (mean cost in the treatment group less mean cost in the usual care group) divided by the difference in outcomes (QALYs in the treatment group less QALYs in the usual care group) Health care system perspective costs includes the intervention and services sponsored by VA. We limited these to care for musculoskeletal disorders. The societal perspective adds the cost of health services received outside of VA and costs incurred by participants, including the value of time spent seeking health services and obtaining self-directed care, and the value of the effect of disability on employment and normal activities. |
| Cost-Effectiveness Acceptability Curves (CEACs) | 36 weeks | Probability that SBIRT is cost-effective compared to usual care over a range of monetary values that a decision-maker might consider the maximum acceptable to avoid to improve pain |
| Non-pharmacological Pain Service Utilization | 36 weeks | Number of modalities of non-opioid pain services used will be assessed using a modified version of the Pain Management Collaboratory's "non-pharmacological and self-care approaches" questionnaire. This questionnaire asks about use of a list of 3 pharmacological and 23 non-pharmacological pain treatment modalities. For each modality, respondents indicate if the treatment was used in the past three months, if the treatment was delivered in an individual or group setting or if done on own (self-care), and the number of sessions/visits attended in the past 3 months. Number of non-pharmacological modalities will be summed. |
| Pain Interference Subscale of Brief Pain Inventory | 36 weeks | Pain interference subscale of Brief Pain Inventory uses a 0-10 numeric rating scale (0=no interference to 10=interferes completely) to measure seven daily activities: general activity, walking, work, mood, enjoyment of life, relations with others, sleep. The pain interference subscale is scored as the mean of the seven interference items. This mean can be used if more than 50% (4/7 items) have been completed on a given administration. |
| Overall Health Measured by EQ-5D-5L | 36 weeks | The Eq-5D-5L is a standardized measure of health status designed for clinical and economic appraisals. It includes a health scale which asks respondents to rate their health today on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state). |
| Individual Substances of Misuse Generated by the ASSIST | 36 weeks | Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) (Version 3.1) measures substance use risk over the last 3 months. It consists of 7 questions about use of and consequences of use for 11 classes of substances (including nicotine, THC and medical THC). Scores for each substance are summed and mapped to a three-point ordinal score of severity. Risk scores for alcohol range from 0-39, where a score of 0-10 indicates "no need for treatment", a score of 11-26 indicates "need for a brief intervention" and a score of 27+ indicates "need for an intensive intervention". Risk scores for tobacco range from 0-31, risk scores for all other substances range from 0-39, where a score of 0-3 indicates "no need for treatment", a score of 4-26 indicates "need for a brief intervention" and a score of 27+ indicates "need for an intensive intervention". Individual substances rated above the "no intervention" threshold will be analyzed here. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORMarc Rosen, MD
Yale University/ VA Connecticut Healthcare System
PRINCIPAL_INVESTIGATORSteve Martino, PhD
Yale University/ VA Connecticut Healthcare System
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| SBIRT-PM Screening, Brief Intervention and Referral to Treatment for Pain Management (SBIRT-PM) was developed to promote engagement in multi-modal non-pharmacological pain management among compensation-seeking Veterans with chronic pain. In SBIRT-PM, a clinician meets with the Veteran after the compensation examination to address the presenting MSD complaint. The clinician addresses Veterans' motivation for multi-modal pain care, and explains how pain can be managed using a variety of non-pharmacological pain management services. The clinician spells out how those services can be accessed at VA. Using permissive language about how pain is commonly self-medicated with substances, the clinician transitions to inquiries about use of prescription and non-prescription substances. The clinician then attempts to motivate Veterans to change their behavior if they are misusing substances. Thus, SBIRT-PM addresses the Veteran's presenting pain complaint first and nascent substance use subsequently.
SBIRT-PM: SBIRT-PM involves an initial telephone-delivered session followed by up to three calls to Veterans in a 12-week period to support Veteran engagement in multi-modal non-pharmacological pain care and to motivate those who misuse substances to change this problematic behavior. SBIRT-PM also includes coordination between the SBIRT-PM clinicians and the PACT nurse case manager after the initial session to support these patient outcomes. | 558 |
| Usual Care A Veteran who completes a Compensation examination ordinarily has no further treatment, referral or debriefing as part of the Compensation examination. Veterans will be advised that they should continue to pursue whatever counseling they need outside the study. | 543 |
| Total | 1,101 |
Baseline characteristics
| Characteristic | SBIRT-PM | Usual Care | Total |
|---|---|---|---|
| Age, Continuous | 39.4 years STANDARD_DEVIATION 11.1 | 38.9 years STANDARD_DEVIATION 10.9 | 39.1 years STANDARD_DEVIATION 11 |
| BPI-Intensity | 5.4 units on a scale STANDARD_DEVIATION 1.2 | 5.4 units on a scale STANDARD_DEVIATION 1.3 | 5.4 units on a scale STANDARD_DEVIATION 1.3 |
| BPI-Interference | 5.1 units on a scale STANDARD_DEVIATION 2.1 | 5.2 units on a scale STANDARD_DEVIATION 2.3 | 5.2 units on a scale STANDARD_DEVIATION 2.2 |
| Education | 15 years STANDARD_DEVIATION 2.4 | 14.7 years STANDARD_DEVIATION 2.2 | 14.9 years STANDARD_DEVIATION 2.3 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 72 Participants | 83 Participants | 155 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 486 Participants | 460 Participants | 946 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Has high-impact chronic pain | 388 Participants | 372 Participants | 760 Participants |
| Impact of COVID on health care access IMPROVED ability to get health care | 26 Participants | 33 Participants | 59 Participants |
| Impact of COVID on health care access no response | 17 Participants | 13 Participants | 30 Participants |
| Impact of COVID on health care access NOT AFFECTED ability to get health care | 314 Participants | 284 Participants | 598 Participants |
| Impact of COVID on health care access Reduced ability to get health care A LITTLE | 127 Participants | 127 Participants | 254 Participants |
| Impact of COVID on health care access Reduced ability to get health care A LOT | 74 Participants | 86 Participants | 160 Participants |
| Legal Involvement | 65 Participants | 65 Participants | 130 Participants |
| Married | 303 Participants | 276 Participants | 579 Participants |
| PEG | 5.7 units on a scale STANDARD_DEVIATION 1.9 | 5.7 units on a scale STANDARD_DEVIATION 2 | 5.7 units on a scale STANDARD_DEVIATION 2 |
| Problematic Alcohol Use | 69 Participants | 98 Participants | 167 Participants |
| Problematic Cannabis Use | 117 Participants | 112 Participants | 229 Participants |
| Problematic Substance Use (any) | 277 Participants | 295 Participants | 572 Participants |
| Problematic Tobacco Use | 189 Participants | 193 Participants | 382 Participants |
| Problematic Use of substance other than tobacco, alcohol, cannabis)) | 22 Participants | 20 Participants | 42 Participants |
| Race/Ethnicity, Customized Black | 64 Participants | 72 Participants | 136 Participants |
| Race/Ethnicity, Customized Unknown/Other | 51 Participants | 47 Participants | 98 Participants |
| Race/Ethnicity, Customized White | 443 Participants | 424 Participants | 867 Participants |
| Sex: Female, Male Female | 69 Participants | 82 Participants | 151 Participants |
| Sex: Female, Male Male | 489 Participants | 461 Participants | 950 Participants |
| Working for pay | 446 Participants | 427 Participants | 873 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1 / 558 | 2 / 543 |
| other Total, other adverse events | 109 / 558 | 89 / 543 |
| serious Total, serious adverse events | 100 / 558 | 92 / 543 |
Outcome results
Primary
Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)
Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed to detect and manage substance use and related problems. Substance use will be measured over the last 3 months using Version 3.1.After a screening question focusing on substances ever used, the ASSIST consists of 7 questions about use of and consequences of use of each of 11 classes of substances over the preceding three months (including nicotine, THC and medical THC). Scores are generated for each substance that are mapped to a three-point ordinal score of severity: no need for treatment, need for a brief intervention and need for an intensive intervention. The number of problem substances are defined as the number of substances above the no intervention threshold \*only participants who had a problem substance reported at baseline were analyzed for this outcome
Time frame: 36 weeks
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| SBIRT-PM | Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | week 0 | 1.47 # substances that need treatment |
| SBIRT-PM | Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | week 12 | 1.32 # substances that need treatment |
| SBIRT-PM | Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | week 36 | 1.26 # substances that need treatment |
| Usual Care | Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | week 0 | 1.47 # substances that need treatment |
| Usual Care | Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | week 12 | 1.19 # substances that need treatment |
| Usual Care | Change in Number of Problem Substances Measured by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) | week 36 | 1.19 # substances that need treatment |
Primary
Change in Pain Intensity Subscale of Brief Pain Inventory
Pain Intensity subscale of the Brief Pain Inventory uses a 0-10 numeric rating scale (0=no pain to 10=pain as bad as you can imagine) to measure four pain severity/intensity items: worst pain in the last 24 hours, least pain in the last 24 hours, average pain, and pain right now. The pain intensity subscale is scored as a composite of the four pain items (mean intensity score).
Time frame: 36 weeks
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| SBIRT-PM | Change in Pain Intensity Subscale of Brief Pain Inventory | week 0 | 5.39 score on a scale |
| SBIRT-PM | Change in Pain Intensity Subscale of Brief Pain Inventory | week 12 | 5.02 score on a scale |
| SBIRT-PM | Change in Pain Intensity Subscale of Brief Pain Inventory | week 36 | 4.60 score on a scale |
| Usual Care | Change in Pain Intensity Subscale of Brief Pain Inventory | week 0 | 5.39 score on a scale |
| Usual Care | Change in Pain Intensity Subscale of Brief Pain Inventory | week 12 | 4.97 score on a scale |
| Usual Care | Change in Pain Intensity Subscale of Brief Pain Inventory | week 36 | 4.86 score on a scale |
Primary
Cost-Effectiveness Acceptability Curves (CEACs)
Probability that SBIRT is cost-effective compared to usual care over a range of monetary values that a decision-maker might consider the maximum acceptable to avoid to improve pain
Time frame: 36 weeks
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| SBIRT-PM | Cost-Effectiveness Acceptability Curves (CEACs) | Threshold of $10k/QALY | .83 cost-effectiveness probability |
| SBIRT-PM | Cost-Effectiveness Acceptability Curves (CEACs) | Threshold of $50k/QALY | .73 cost-effectiveness probability |
| SBIRT-PM | Cost-Effectiveness Acceptability Curves (CEACs) | Threshold of $250k/QALY | .29 cost-effectiveness probability |
| Usual Care | Cost-Effectiveness Acceptability Curves (CEACs) | Threshold of $10k/QALY | .83 cost-effectiveness probability |
| Usual Care | Cost-Effectiveness Acceptability Curves (CEACs) | Threshold of $50k/QALY | .73 cost-effectiveness probability |
| Usual Care | Cost-Effectiveness Acceptability Curves (CEACs) | Threshold of $250k/QALY | .29 cost-effectiveness probability |
Primary
Cost-Effectiveness Ratios (ICERs)
Total costs divided by quality-adjusted life years
Time frame: 36 weeks
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| SBIRT-PM | Cost-Effectiveness Ratios (ICERs) | VA perspective | -86925 $/Quality-adjusted life years |
| SBIRT-PM | Cost-Effectiveness Ratios (ICERs) | Societal perspective | 129527 $/Quality-adjusted life years |
| Usual Care | Cost-Effectiveness Ratios (ICERs) | VA perspective | -86925 $/Quality-adjusted life years |
| Usual Care | Cost-Effectiveness Ratios (ICERs) | Societal perspective | 129527 $/Quality-adjusted life years |
Secondary
Individual Substances of Misuse Generated by the ASSIST
Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) (Version 3.1) measures substance use risk over the last 3 months. It consists of 7 questions about use of and consequences of use for 11 classes of substances (including nicotine, THC and medical THC). Scores for each substance are summed and mapped to a three-point ordinal score of severity. Risk scores for alcohol range from 0-39, where a score of 0-10 indicates no need for treatment, a score of 11-26 indicates need for a brief intervention and a score of 27+ indicates need for an intensive intervention. Risk scores for tobacco range from 0-31, risk scores for all other substances range from 0-39, where a score of 0-3 indicates no need for treatment, a score of 4-26 indicates need for a brief intervention and a score of 27+ indicates need for an intensive intervention. Individual substances rated above the no intervention threshold will be analyzed here.
Time frame: 36 weeks
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Tobacco, week 12 | 11.48 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Alcohol, week 36 | 12.93 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Alcohol, week 0 | 19.32 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Marijuana, week 0 | 9.14 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Tobacco, week 36 | 11.09 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Marijuana, week 12 | 7.83 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Alcohol, week 12 | 15.81 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Marijuana, week 36 | 7.33 score on a scale |
| SBIRT-PM | Individual Substances of Misuse Generated by the ASSIST | Tobacco, week 0 | 14.05 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Marijuana, week 36 | 6.51 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Tobacco, week 0 | 13.35 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Tobacco, week 12 | 11.97 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Tobacco, week 36 | 10.80 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Alcohol, week 0 | 17.72 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Alcohol, week 12 | 13.04 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Alcohol, week 36 | 11.82 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Marijuana, week 0 | 8.80 score on a scale |
| Usual Care | Individual Substances of Misuse Generated by the ASSIST | Marijuana, week 12 | 6.69 score on a scale |
Secondary
Non-pharmacological Pain Service Utilization
Number of modalities of non-opioid pain services used will be assessed using a modified version of the Pain Management Collaboratory's non-pharmacological and self-care approaches questionnaire. This questionnaire asks about use of a list of 3 pharmacological and 23 non-pharmacological pain treatment modalities. For each modality, respondents indicate if the treatment was used in the past three months, if the treatment was delivered in an individual or group setting or if done on own (self-care), and the number of sessions/visits attended in the past 3 months. Number of non-pharmacological modalities will be summed.
Time frame: 36 weeks
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| SBIRT-PM | Non-pharmacological Pain Service Utilization | week 0 | 2.72 # pain treatment modalities used |
| SBIRT-PM | Non-pharmacological Pain Service Utilization | week 12 | 3.48 # pain treatment modalities used |
| SBIRT-PM | Non-pharmacological Pain Service Utilization | week 36 | 3.33 # pain treatment modalities used |
| Usual Care | Non-pharmacological Pain Service Utilization | week 0 | 2.49 # pain treatment modalities used |
| Usual Care | Non-pharmacological Pain Service Utilization | week 12 | 3.31 # pain treatment modalities used |
| Usual Care | Non-pharmacological Pain Service Utilization | week 36 | 3.00 # pain treatment modalities used |
Secondary
Overall Health Measured by EQ-5D-5L
The Eq-5D-5L is a standardized measure of health status designed for clinical and economic appraisals. It includes a health scale which asks respondents to rate their health today on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state).
Time frame: 36 weeks
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| SBIRT-PM | Overall Health Measured by EQ-5D-5L | week 0 | 65.13 score on a scale |
| SBIRT-PM | Overall Health Measured by EQ-5D-5L | week 12 | 66.72 score on a scale |
| SBIRT-PM | Overall Health Measured by EQ-5D-5L | week 36 | 68.61 score on a scale |
| Usual Care | Overall Health Measured by EQ-5D-5L | week 12 | 68.82 score on a scale |
| Usual Care | Overall Health Measured by EQ-5D-5L | week 0 | 65.74 score on a scale |
| Usual Care | Overall Health Measured by EQ-5D-5L | week 36 | 69.20 score on a scale |
Secondary
Pain Interference Subscale of Brief Pain Inventory
Pain interference subscale of Brief Pain Inventory uses a 0-10 numeric rating scale (0=no interference to 10=interferes completely) to measure seven daily activities: general activity, walking, work, mood, enjoyment of life, relations with others, sleep. The pain interference subscale is scored as the mean of the seven interference items. This mean can be used if more than 50% (4/7 items) have been completed on a given administration.
Time frame: 36 weeks
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| SBIRT-PM | Pain Interference Subscale of Brief Pain Inventory | week 0 | 5.15 score on a scale |
| SBIRT-PM | Pain Interference Subscale of Brief Pain Inventory | week 12 | 4.93 score on a scale |
| SBIRT-PM | Pain Interference Subscale of Brief Pain Inventory | week 36 | 4.35 score on a scale |
| Usual Care | Pain Interference Subscale of Brief Pain Inventory | week 0 | 5.16 score on a scale |
| Usual Care | Pain Interference Subscale of Brief Pain Inventory | week 12 | 4.78 score on a scale |
| Usual Care | Pain Interference Subscale of Brief Pain Inventory | week 36 | 4.61 score on a scale |