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Information about ongoing health services research and public health projects

Optimizing Patient Engagement in a Novel pain management initiative (OPEN)
Investigator (PI): Green, Traci
Performing Organization (PO): (Current): Inflexxion / (617) 332-6028
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2019
Record Source/Award ID: PCORI/IHS-1306-02960
Funding: Total Award Amount: $2,080,940
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Chronic pain is a condition that affects the most fundamental aspects of quality of life. Treatment for chronic pain is challenging and usually takes the form of opioid medication therapy. But chronic opioid therapy is also associated with high rates of emergency department use, drug diversion, addiction, and unintentional overdose deaths. The new RI Medicaid Chronic Pain Initiative (CPI) targets patients who are both high emergency department users and experiencing chronic pain. In the CPI, patients can be prescribed an integrated treatment plan of massage, chiropractic, or acupuncture therapies. This is a novel approach to chronic pain care, but retention and patient engagement are low. It is important to understand why involvement in the CPI is low, how to improve the patient experience, and how to support the prescribed CAM therapies. This study has two aims. The first is to identify what helps to keep patients involved with the CPI program and to identify features of an ideal text-message-based program for people enrolled in the CPI. The second aim is to develop the text-message-based program (OPENtext), then find out how useful this intervention is compared to a patient navigator intervention (OPENnav) for increasing patient engagement, improving patients' motivation to manage their chronic pain, and improving patient confidence in self-managing their chronic pain condition. We will conduct qualitative interviews with 24 patients, 12 providers, and 12 administrators. Goals of the interviews will be to understand the patient experience in the CPI, including experiences with the navigation approach currently in place; to identify barriers and facilitators to CPI participation; and to learn how technology especially cell phone text-messaging could help support their pain care and CPI engagement. These interviews will help develop a text-message-based intervention and provide feedback to existing patient navigator programming. Next, we will develop and test the text-message patient support intervention that will contain patient-identified topics and concerns that emerge from the qualitative interviews and topic areas discussed by a stakeholder advisory board. Theories of behavior change will be used to help with message development, and patients will take part in helping to test and fine-tune the intervention. Last, we will compare the text-message and patient navigation interventions in a randomized controlled study with 300 patients over a nine-month period. We will see which approach helps patients increase their involvement in the CPI and better manage their chronic pain. If successful, chronic pain patients across Medicaid programs could benefit from use of the patient navigation or the text-message intervention.
MeSH Terms:
  • Analgesics, Opioid /therapeutic use
  • Chronic Pain /*therapy
  • Emergency Service, Hospital /organization & administration
  • Health Services Accessibility
  • Humans
  • Medicaid
  • Pain Management /*methods
  • Patient Navigation
  • * Patient Participation
  • Patient Satisfaction
  • Program Development
  • Quality of Life
  • Text Messaging
  • United States
Country: United States
State: Massachusetts
Zip Code: 02464
UI: 20143569
CTgovId: NCT02136108
Project Status: Completed
Record History: ('2018: Project extended to 2019. 2017: Project extended to 2018.',)