VA Connecticut Healthcare System, West Haven, Connecticut, USA.
Yale University School of Medicine, New Haven, Connecticut, USA.
Pain Pract. 2022 Jan;22(1):28-38. doi: 10.1111/papr.13023. Epub 2021 Jun 26.
Musculoskeletal disorders often lead to chronic pain in Veterans. Chronic pain puts sufferers at risk for substance misuse, and early intervention is needed for both conditions. This pilot study tested the feasibility and acceptability of a Screening, Brief Intervention, and Referral to Treatment for Pain Management intervention (SBIRT-PM) to help engage Veterans seeking disability compensation for painful musculoskeletal disorders in multimodal pain treatment and to reduce risky substance use, when indicated.
This pilot study enrolled 40 Veterans from 8 medical centers across New England in up to 4 sessions of telephone-based counseling using a motivational interviewing framework. Counseling provided education about, and facilitated engagement in, multimodal pain treatments. Study eligibility required Veterans be engaged in no more than 2 Veteran Affairs (VA) pain treatment modalities, and study participation involved a 12-week postassessment and semistructured interview about the counseling process.
Majorities of enrolled Veterans screened positive for comorbid depression and problematic substance use. Regarding the offered counseling, 80% of participants engaged in at least one session, with a mean of 3 sessions completed. Ninety percent of participants completed the postassessment. Numerically, most measures improved slightly from baseline to week 12. In semistructured interviews, participants described satisfaction with learning about new pain care services, obtaining assistance connecting to services, and receiving support from their counselors.
It was feasible to deliver SBIRT-PM to Veterans across New England to promote engagement in multimodal pain treatment and to track study outcomes over 12 weeks. Preliminary results suggest SBIRT-PM was well-received and has promise for the targeted outcomes.
肌肉骨骼疾病常导致退伍军人出现慢性疼痛。慢性疼痛使患者有滥用药物的风险，因此需要对这两种情况进行早期干预。这项试点研究测试了对疼痛管理的筛查、简短干预和转介治疗（SBIRT-PM）的可行性和可接受性，以帮助因肌肉骨骼疼痛寻求残疾补偿的退伍军人参与多模式疼痛治疗，并在有需要时减少危险的物质使用。
本试点研究纳入了来自新英格兰 8 个医疗中心的 40 名退伍军人，他们最多参加了 4 次基于电话的咨询，采用动机访谈框架。咨询提供了关于多模式疼痛治疗的教育，并促进了其参与。研究资格要求退伍军人参与的退伍军人事务部（VA）疼痛治疗方式不超过 2 种，研究参与包括 12 周的后续评估和关于咨询过程的半结构化访谈。
大多数入组的退伍军人筛查出共病性抑郁和有问题的物质使用。关于所提供的咨询，80%的参与者至少参加了一次，平均完成了 3 次。90%的参与者完成了后续评估。从基线到第 12 周，大多数指标略有改善。在半结构化访谈中，参与者描述了对学习新的疼痛护理服务、获得帮助联系服务以及获得顾问支持的满意度。
在新英格兰向退伍军人提供 SBIRT-PM 以促进多模式疼痛治疗的参与并在 12 周内跟踪研究结果是可行的。初步结果表明，SBIRT-PM 受到了很好的欢迎，并有望实现目标结果。
