A Brief Peer Support Intervention for Veterans with Chronic Musculoskeletal Pain: a Pilot Study of Feasibility and Effectiveness

Overview

Journal Pain Med

Specialties Critical Care
Neurology
Psychiatry

Date 2014 Oct 15

PMID 25312858

Citations 25

Authors

Marianne S Matthias

Alan B McGuire

Marina Kukla

Joanne Daggy

Laura J Myers

Matthew J Bair

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to pilot test a peer support intervention, involving peer delivery of pain self-management strategies, for veterans with chronic musculoskeletal pain.

Design: Pretest/posttest with 4-month intervention period.

Methods: Ten peer coaches were each assigned 2 patients (N = 20 patients). All had chronic musculoskeletal pain. Guided by a study manual, peer coach-patient pairs were instructed to talk biweekly for 4 months. Pain was the primary outcome and was assessed with the PEG, a three-item version of the Brief Pain Inventory, and the PROMIS Pain Interference Questionnaire. Several secondary outcomes were also assessed. To assess change in outcomes, a linear mixed model with a random effect for peer coaches was applied.

Results: Nine peer coaches and 17 patients completed the study. All were male veterans. Patients' pain improved at 4 months compared with baseline but did not reach statistical significance (PEG: P = 0.33, ICC [intra-class correlation] = 0.28, Cohen's d = -0.25; PROMIS: P = 0.17, d = -0.35). Of secondary outcomes, self-efficacy (P = 0.16, ICC = 0.56, d = 0.60) and pain centrality (P = 0.06, ICC = 0.32, d = -0.62) showed greatest improvement, with moderate effect sizes.

Conclusions: This study suggests that peers can effectively deliver pain self-management strategies to other veterans with pain. Although this was a pilot study with a relatively short intervention period, patients improved on several outcomes.

Citing Articles

Volunteer Peer Support for Chronic Pain Self-Management: A Qualitative Study of Benefits and Barriers.

Matthias M, Adams J, Eliacin J J Gen Intern Med. 2024; .

PMID: 39586946 DOI: 10.1007/s11606-024-09217-4.

Balancing between being the most valuable player (MVP) and passing the ball: a qualitative study of support when living with chronic pain in Sweden.

Lilja V, Wallstrom S, Saarijarvi M, Lundberg M, Segertoft V, Ekman I BMJ Open. 2024; 14(1):e079229.

PMID: 38296288 PMC: 10831426. DOI: 10.1136/bmjopen-2023-079229.

Exploring mHealth applications for self-management of chronic low back pain: A survey of features and benefits.

Kheirinejad S, Visuri A, Suryanarayana S, Hosio S Heliyon. 2023; 9(6):e16586.

PMID: 37346357 PMC: 10279785. DOI: 10.1016/j.heliyon.2023.e16586.

Leveraging the Expertise of the Community: A Case for Expansion of a Peer Workforce in Child, Adolescent, and Family Mental Health.

Robertson H, Biel M, Hayes K, Snowden S, Curtis L, Charlot-Swilley D Int J Environ Res Public Health. 2023; 20(11).

PMID: 37297524 PMC: 10252488. DOI: 10.3390/ijerph20115921.

Peer Support Activities for Veterans, Serving Members, and Their Families: Results of a Scoping Review.

Mercier J, Hosseiny F, Rodrigues S, Friio A, Bremault-Phillips S, Shields D Int J Environ Res Public Health. 2023; 20(4).

PMID: 36834328 PMC: 9964749. DOI: 10.3390/ijerph20043628.

References

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

Butchart A, Kerr E, Heisler M, Piette J, Krein S . Experience and management of chronic pain among patients with other complex chronic conditions. Clin J Pain. 2009; 25(4):293-8. PMC: 2709743. DOI: 10.1097/AJP.0b013e31818bf574. View

Maeng D, Martsolf G, Scanlon D, Christianson J . Care coordination for the chronically ill: understanding the patient's perspective. Health Serv Res. 2012; 47(5):1960-79. PMC: 3513613. DOI: 10.1111/j.1475-6773.2012.01405.x. View

Cecil H, Stanley M, Carrion P, Swann A . Psychometric properties of the MSPSS and NOS in psychiatric outpatients. J Clin Psychol. 1995; 51(5):593-602. DOI: 10.1002/1097-4679(199509)51:5<593::aid-jclp2270510503>3.0.co;2-w. View

Krebs E, Bair M, Damush T, Tu W, Wu J, Kroenke K . Comparative responsiveness of pain outcome measures among primary care patients with musculoskeletal pain. Med Care. 2010; 48(11):1007-14. PMC: 4876043. DOI: 10.1097/MLR.0b013e3181eaf835. View

Salyers M, Matthias M, Spann C, Lydick J, Rollins A, Frankel R . The role of patient activation in psychiatric visits. Psychiatr Serv. 2009; 60(11):1535-9. PMC: 2777630. DOI: 10.1176/appi.ps.60.11.1535. View

Lorig K, Chastain R, Ung E, Shoor S, HOLMAN H . Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum. 1989; 32(1):37-44. DOI: 10.1002/anr.1780320107. View

Newman S, Steed L, Mulligan K . Self-management interventions for chronic illness. Lancet. 2004; 364(9444):1523-37. DOI: 10.1016/S0140-6736(04)17277-2. View

Lorig K, Mazonson P, HOLMAN H . Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum. 1993; 36(4):439-46. DOI: 10.1002/art.1780360403. View

10.

Osman A, Lamis D, Freedenthal S, Gutierrez P, McNaughton-Cassill M . The multidimensional scale of perceived social support: analyses of internal reliability, measurement invariance, and correlates across gender. J Pers Assess. 2013; 96(1):103-12. DOI: 10.1080/00223891.2013.838170. View

11.

Hibbard J, Mahoney E, Stockard J, Tusler M . Development and testing of a short form of the patient activation measure. Health Serv Res. 2005; 40(6 Pt 1):1918-30. PMC: 1361231. DOI: 10.1111/j.1475-6773.2005.00438.x. View

12.

Kroenke K, Bair M, Damush T, Hoke S, Nicholas G, Kempf C . Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study: design and practical implications of an intervention for comorbid pain and depression. Gen Hosp Psychiatry. 2007; 29(6):506-17. DOI: 10.1016/j.genhosppsych.2007.08.005. View

13.

Rothman K . No adjustments are needed for multiple comparisons. Epidemiology. 1990; 1(1):43-6. View

14.

Dennis C . Peer support within a health care context: a concept analysis. Int J Nurs Stud. 2003; 40(3):321-32. DOI: 10.1016/s0020-7489(02)00092-5. View

15.

Hibbard J, Greene J . What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff (Millwood). 2013; 32(2):207-14. DOI: 10.1377/hlthaff.2012.1061. View

16.

Salyers M, Matthias M, Sidenbender S, Green A . Patient activation in schizophrenia: insights from stories of illness and recovery. Adm Policy Ment Health. 2012; 40(5):419-27. DOI: 10.1007/s10488-012-0435-7. View

17.

Amtmann D, Cook K, Jensen M, Chen W, Choi S, Revicki D . Development of a PROMIS item bank to measure pain interference. Pain. 2010; 150(1):173-182. PMC: 2916053. DOI: 10.1016/j.pain.2010.04.025. View

18.

Kroenke K, Bair M, Damush T, Wu J, Hoke S, Sutherland J . Optimized antidepressant therapy and pain self-management in primary care patients with depression and musculoskeletal pain: a randomized controlled trial. JAMA. 2009; 301(20):2099-110. PMC: 2884224. DOI: 10.1001/jama.2009.723. View

19.

Kerns R, Otis J, Rosenberg R, Reid M . Veterans' reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system. J Rehabil Res Dev. 2004; 40(5):371-9. DOI: 10.1682/jrrd.2003.09.0371. View

20.

Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J . Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. 2002; 48(2):177-87. DOI: 10.1016/s0738-3991(02)00032-0. View