Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.

Journal Article (Journal Article)

BACKGROUND: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging development; however, what constitutes best practice for nonpharmacologic management of low back pain (LBP) is largely unknown. DESIGN: The Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) trial is an embedded pragmatic cluster-randomized trial that will examine the effectiveness of two different care pathways for LBP. Sixteen primary care clinics will be randomized 1:1 to receive training in delivery of 1) an integrated sequenced-care pathway or 2) a coordinated pain navigator pathway. Primary outcomes are pain interference and physical function (Patient-Reported Outcomes Measurement Information System Short Form [PROMIS-SF]) collected in the electronic health record at 3 months (n=1,680). A subset of veteran participants (n=848) have consented to complete additional surveys at baseline and at 3, 6, and 12 months for supplementary pain and other measures. SUMMARY: AIM-Back care pathways will be tested for effectiveness, and treatment heterogeneity will be investigated to identify which veterans may respond best to a given pathway. Health care utilization patterns (including opioid use) will also be compared between care pathways. Therefore, the AIM-Back trial will provide important information that can inform the future delivery of nonpharmacologic treatment of LBP.

Full Text

Duke Authors

Cited Authors

  • George, SZ; Coffman, CJ; Allen, KD; Lentz, TA; Choate, A; Goode, AP; Simon, CB; Grubber, JM; King, H; Cook, CE; Keefe, FJ; Ballengee, LA; Naylor, J; Brothers, JL; Stanwyck, C; Alkon, A; Hastings, SN

Published Date

  • December 12, 2020

Published In

Volume / Issue

  • 21 / Suppl 2

Start / End Page

  • S62 - S72

PubMed ID

  • 33313728

Pubmed Central ID

  • PMC7734660

Electronic International Standard Serial Number (EISSN)

  • 1526-4637

Digital Object Identifier (DOI)

  • 10.1093/pm/pnaa348


  • eng

Conference Location

  • England