Benefits of Intervention in Managing Chronic PainKyle L. Benbow1 , Megan Miller1, Eric Scott2, Kurt Kroenke3

1Department of Psychology, Purdue School of Science, 2Riley’s Children’s Hospital, IU School of Medicine, 3Roudebush VA Medical Center, IU School of Medicine

IntroductionA study in 2011 showed that at least 100 million adult Americans have common chronic pain conditions. The prevalence is higher amongst veterans as recent studies of returning troops from the War in Iraq show that 81.5% of those veterans have chronic pain conditions. Efforts are being made to better understand the cognitive and behavioral components that drive pain. While the goal of treatment is to reduce or eliminate the locus of pain, an alternative model known as intervention, focuses more on self-management and cognitive change. Intervention is a more effective treatment in chronic pain management, as it helps individuals better respond to pain as well as lower the amount of days which they are disabled due to pain.

MethodsAs part of the intervention group, participants received:• Automated home-based monitoring• Selective care manager calls • Weekly case review with MD specialist• Escalation of therapy using an

evidence-based stepped care analgesic algorithm

Statistical Analysis• Participants pain was measured using

the Brief Pain Inventory (BPI), which is a self-report assessing the severity of pain and impact of pain on daily functioning

• Total disability was measured using self-reported number of days of work missed over a 4 week period

• Independent-samples t-test was conducted to compare BPI scores and total disability days between the intervention group and the control group.

Summary of ResearchThese results show pain management through intervention has a positive effect on pain as compared to usual care. This positive effect on pain can reverberate to help other issues that those who suffer from chronic pain deal with, such as depression, anxiety, and outlook. The goal of intervention aims to empower patients to become active participants in the management of their illness and feel more in control of their pain in hopes of giving them a better outlook of their situation. These trials show the benefits of the use of intervention in chronic pain management, helping individual cope with pain and become more functional in their everyday lives, despite their conditions.

Participants250 participants were recruited from the VA of Indianapolis. The group was randomly selected to either receive intervention or continue receiving usual care. 124 were assigned intervention while 126 continued receiving usual careRequirements• Musculoskeletal (≥ 75% of chronic pain

in veterans)• Moderately severe (BPI severity ≥ 5)• Persistent (≥ 3 mo despite 2 Analgesic

trials)• Exclusions: psychosis; no phone or

internet access; terminal illness

Demographics: Intervention/Usual Care• Age: 55.0 (9.0) /55.3 (7.9) • Sex: 87.9% male/ 77.8% male• Race: 71.8% white/ 81.8% white• Education: 75.8 >High School/72.2 >High

School

• The participants in the intervention group (M=3.57, SD=2.22) demonstrated a significantly lower BPI scores than the participants in the control group (M=4.59, SD=2.13); (t(248)= 41.27, p<0.05one-tailed)

• These results indicate that intervention has an significantly better effect on pain than receiving usual care.

• Participants receiving intervention saw a significant decrease in total disability days (M=8.1, SD=7.9), as compared to those who received usual care (M=9.5, SD=8.8); t(248)=14.74, p<0.05one-tailed)

• These results indicate that intervention contributes significantly to a help prevent disability days, as compared to receiving usual care.

• Participants in the intervention group showed a good adherence and satisfaction with automate and nurse components of intervention

Intervention Control0

1

2

3

4

5

BPI scores

Results

Intervention Control77.5

88.5

99.510

Total Disability Days