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

Publication ,  Journal Article
George, SZ; Coffman, CJ; Allen, KD; Lentz, TA; Choate, A; Goode, AP; Simon, CB; Grubber, JM; King, H; Cook, CE; Keefe, FJ; Ballengee, LA ...
Published in: Pain Med
December 12, 2020

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.

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Published In

Pain Med

DOI

EISSN

1526-4637

Publication Date

December 12, 2020

Volume

21

Issue

Suppl 2

Start / End Page

S62 / S72

Location

England

Related Subject Headings

  • Veterans
  • Time Factors
  • Surveys and Questionnaires
  • Randomized Controlled Trials as Topic
  • Pain Management
  • Low Back Pain
  • Humans
  • Anesthesiology
  • 5203 Clinical and health psychology
  • 4203 Health services and systems
 

Citation

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George, S. Z., Coffman, C. J., Allen, K. D., Lentz, T. A., Choate, A., Goode, A. P., … Hastings, S. N. (2020). Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial. Pain Med, 21(Suppl 2), S62–S72. https://doi.org/10.1093/pm/pnaa348
George, Steven Z., Cynthia J. Coffman, Kelli D. Allen, Trevor A. Lentz, Ashley Choate, Adam P. Goode, Corey B. Simon, et al. “Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.Pain Med 21, no. Suppl 2 (December 12, 2020): S62–72. https://doi.org/10.1093/pm/pnaa348.
George SZ, Coffman CJ, Allen KD, Lentz TA, Choate A, Goode AP, et al. Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial. Pain Med. 2020 Dec 12;21(Suppl 2):S62–72.
George, Steven Z., et al. “Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.Pain Med, vol. 21, no. Suppl 2, Dec. 2020, pp. S62–72. Pubmed, doi:10.1093/pm/pnaa348.
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. Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial. Pain Med. 2020 Dec 12;21(Suppl 2):S62–S72.
Journal cover image

Published In

Pain Med

DOI

EISSN

1526-4637

Publication Date

December 12, 2020

Volume

21

Issue

Suppl 2

Start / End Page

S62 / S72

Location

England

Related Subject Headings

  • Veterans
  • Time Factors
  • Surveys and Questionnaires
  • Randomized Controlled Trials as Topic
  • Pain Management
  • Low Back Pain
  • Humans
  • Anesthesiology
  • 5203 Clinical and health psychology
  • 4203 Health services and systems