Whole Health Options and Pain Education (wHOPE): A Pragmatic Trial Comparing Whole Health Team Vs Primary Care Group Education to Promote Nonpharmacological Strategies to Improve Pain, Functioning, and Quality of Life in Veterans-Rationale, Methods,...

Overview

Journal Pain Med

Specialties Critical Care
Neurology
Psychiatry

Date 2020 Dec 14

PMID 33313734

Citations 16

Authors

Karen H Seal

William C Becker

Jennifer L Murphy

Natalie Purcell

Lauren M Denneson

Benjamin J Morasco

Aaron M Martin

Kavitha Reddy

Theresa Van Iseghem

Erin E Krebs

Jacob M Painter

Hildi Hagedorn

Jeffrey M Pyne

John Hixon

Shira Maguen

Thomas C Neylan

Brian Borsari

Beth DeRonne

Carolyn Gibson

Marianne S Matthias

Joseph W Frank

Akshaya Krishnaswamy

Yongmei Li

Daniel Bertenthal

Allan Chan

Alejandro Nunez

Nicole McCamish

Affiliations

Soon will be listed here.

Abstract

Background: The Whole Health model of the U.S. Department of Veterans Affairs (VA) emphasizes holistic self-care and multimodal approaches to improve pain, functioning, and quality of life. wHOPE (Whole Health Options and Pain Education) seeks to be the first multisite pragmatic trial to establish evidence for the VA Whole Health model for chronic pain care.

Design: wHOPE is a pragmatic randomized controlled trial comparing a Whole Health Team (WHT) approach to Primary Care Group Education (PC-GE); both will be compared to Usual VA Primary Care (UPC). The WHT consists of a medical provider, a complementary and integrative health (CIH) provider, and a Whole Health coach, who collaborate with VA patients to create a Personalized Health Plan emphasizing CIH approaches to chronic pain management. The active comparator, PC-GE, is adapted group cognitive behavioral therapy for chronic pain. The first aim is to test whether the WHT approach is superior to PC-GE and whether both are superior to UPC in decreasing pain interference in functioning in 750 veterans with moderate to severe chronic pain (primary outcome). Secondary outcomes include changes in pain severity, quality of life, mental health symptoms, and use of nonpharmacological and pharmacological therapies for pain. Outcomes will be collected from the VA electronic health record and patient-reported data over 12 months of follow-up. Aim 2 consists of an implementation-focused process evaluation and budget impact analysis.

Summary: This trial is part of the Pain Management Collaboratory, which seeks to create national-level infrastructure to support evidence-based nonpharmacological pain management approaches for veterans and military service personnel.

Citing Articles

Natural Product Use for Chronic Pain: A New Survey of Patterns of Use, Beliefs, Concerns, and Disclosure to Providers.

Seal K, Feinberg T, Moore L, Woodruff N, Purcell N, Bertenthal D Glob Adv Integr Med Health. 2025; 14:27536130251320101.

PMID: 40026674 PMC: 11869316. DOI: 10.1177/27536130251320101.

Impact of the COVID-19 pandemic on participants in pragmatic clinical trials for chronic pain: implications for trial outcomes and beyond.

Sellinger J, Gilstad-Hayden K, Lazar C, Seal K, Purcell N, Burgess D Pain Med. 2024; 25(Supplement_1):S17-S27.

PMID: 39514885 PMC: 11548862. DOI: 10.1093/pm/pnae060.

Pragmatic clinical trials as hybrid effectiveness-implementation studies to shrink the evidence-to-practice gap for chronic pain management.

Midboe A, Seal K, Burgess D, Rosen M, Martino S Pain Med. 2024; 25(Supplement_1):S77-S79.

PMID: 39514879 PMC: 11548854. DOI: 10.1093/pm/pnae067.

Recommendations for monitoring adherence and fidelity in pragmatic trials based on experience in the Pain Management Collaboratory.

Dziura J, Gilstad-Hayden K, Coffman C, Long C, Yu Q, Buta E Pain Med. 2024; 25(Supplement_1):S41-S48.

PMID: 39514878 PMC: 11548857. DOI: 10.1093/pm/pnae080.

Adapting to change: experiences and recommendations from the Pain Management Collaboratory on modifying statistical analysis plans.

Yu Q, George S, Kyriakides T, Rhon D, Morasco B, Dziura J Pain Med. 2024; 25(Supplement_1):S49-S53.

PMID: 39514871 PMC: 11548855. DOI: 10.1093/pm/pnae073.

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