Virtual Pain Care Management (COVID-19)

Overview

The COVID-19 pandemic is exacerbating the challenges faced by Veterans at risk of opioid overdose including Veterans prescribed moderate-to-high dose long-term opioid therapy (LTOT) whose usual treatment resources and coping strategies may be inaccessible. This project combines established VA care components to deploy and evaluate virtual models of care for Veterans on high-risk LTOT to meet the dual challenges of maintaining social distancing and delivery high quality care.

Full Title of Study: “Virtual Pain Care for High Risk Veterans on Opioids During COVID19 (and Beyond)”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Health Services Research
    • Masking: None (Open Label)
  • Study Primary Completion Date: May 31, 2021

Interventions

  • Other: VCPM
    • VCPM is a multi-component intervention consisting of already-established care processes and materials.

Arms, Groups and Cohorts

  • Other: VCPM
    • VCPM is a multi-component intervention consisting of already-established care processes and materials. First, the patient is mailed or emailed (based on their preference) an informational packet prior to intake appointment. Second, using the collaborative medication management model established in VHA,3 the intake appointment is led by the CPS using a standardized intake evaluation. The CPS and physician design a plan presented to the patient. If BUP switch is offered and accepted, the physician completes additional brief evaluations, including a history, medication review, treatment planning, and discussion of other VCPM components, using two-way audio-video visits (with telephone as a back-up).

Clinical Trial Outcome Measures

Primary Measures

  • the percent of patients who agree to Buprenorphine transfer
    • Time Frame: 30 days
    • Although the project will use shared decision-making with Veterans, the percent of patients who agree to transfer will provide a realistic indicator of overall feasibility/acceptability.

Secondary Measures

  • percent of complete tapering or BUP transition
    • Time Frame: 60 days
    • overall measure of engagement

Participating in This Clinical Trial

Inclusion Criteria

  • Eligible participants must currently receive LTOT for chronic pain at 50 mg morphine equivalent daily dose Exclusion Criteria:

Exclusion criteria at baseline are:

  • dementia diagnosis or moderate-severe cognitive impairment – unstable or severe untreated psychiatric disorder or medical disease that requires hospitalization – documentation of suspected controlled substance diversion – inability to communicate by phone

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • VA Office of Research and Development
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Brent Adams Moore, PhD, Principal Investigator, VA Connecticut Healthcare System West Haven Campus, West Haven, CT

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