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Improving the quality of care for pain and depression in persons with multiple sclerosis
Investigator (PI): Ehde, Dawn
Performing Organization (PO): (Current): University of Washington, School of Medicine, Department of Rehabilitation Medicine / (206) 744-3167
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2013
Final Year: 2019
Record Source/Award ID: PCORI/IH-1304-6379
Funding: Total Award Amount: $2,082,785
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Number of Subjects: 200
Abstract: Background: It is common for people with multiple sclerosis (MS) to have depression and chronic pain. Individuals with MS who have depression and/or pain often use more health care services, benefit less from treatment, and have poorer quality of life. While evidence-based medical and behavioral treatments for depression and pain exist, they are often not offered or accessible to persons with MS. As a result, chronic pain and depression are under-treated in people with MS. One way to better treat these problems is through a collaborative care approach. In this approach, a care manager (nurse supervised by expert physicians, psychiatrists, and psychologists) helps coordinate and provide high-quality, evidence-based treatments for depression and pain. The care manager also makes sure that the care is focused on the patient's goals and preferences. The care is provided by phone or in person based on the patient's preference. Although this approach has been used successfully with patients with many different conditions, it has never been tested in patients with MS, pain, and depression. Objectives: Our objectives are to (1) test the benefits of the patient-centered collaborative care treatment approach for persons with MS who also have depression and/or pain; and also (2) test whether this approach improves quality of life, patient satisfaction, adherence to other treatments, and quality of care in the MS care system. Methods: Participants will be 200 outpatients with MS from a specialty MS center who have depression and/or chronic pain. Half of the participants will receive the treatment that is typical for patients in the MS center (usual care), while the other half will receive treatment using the collaborative care approach. Participants in the collaborative care group will meet regularly in person or by telephone with a nurse who coordinates their depression and pain treatments and provides strategies for better managing their symptoms. All participants will be involved in the treatment phase of the study for 16 weeks. Participants will also complete telephone interviews before treatment begins, immediately after, and 6 months after the treatment ends. During these interviews participants will be asked questions about their pain, depression, satisfaction with care, and quality of life to compare the two care approaches. Projected patient outcomes: We anticipate that those in the collaborative care approach will have better controlled pain and depression and better quality of life, satisfaction with care, adherence to other MS treatments, and quality of care compared to those in the usual care approach. The results of this study may help patients, clinicians, health care system leaders, and policy makers make decisions about the benefits of this type of coordinated care approach for depression and pain in MS care.
MeSH Terms:
  • Chronic Pain
  • Continuity of Patient Care
  • Depression /*complications
  • /*therapy
  • Evidence-Based Medicine
  • Follow-Up Studies
  • Health Policy
  • Humans
  • Multiple Sclerosis /*complications
  • /psychology
  • Pain Management /*methods
  • Patient Compliance
  • Patient Satisfaction
  • Patient-Centered Care
  • Quality of Health Care
  • Quality of Life
Country: United States
State: Washington
Zip Code: 98104
UI: 20143554
CTgovId: NCT02137044
Project Status: Completed
Record History: ('2017: Project extended to 2018.',) ('2018: Project extended to 2019.',)