(518) Facilitators and barriers to peer support for chronic pain self-management in veterans

Abstract Objective Pain self-management information and support, delivered by peers, are a potentially useful approach to help patients who are struggling to manage their chronic pain. Before implementation into clinical settings, it is important to understand factors that may influence the success of implementation. The purpose of this study was to explore facilitators and barriers to implementation of peer support for chronic pain. Design Semistructured interviews were conducted with clinicians who provide care to patients with chronic pain, regarding their perceptions of the proposed peer support intervention. Setting A single US Veterans Affairs Medical Center. Subjects Using maximum variation sampling, 15 providers were interviewed (11 women, four men). Clinicians’ disciplines included primary care, physical therapy, nursing, clinical psychology, social work, and pharmacy. Results Findings indicated that clinicians 1) had an overall positive perception of the intervention; 2) had specific intervention outcomes they wanted for patients; 3) anticipated that the intervention could positively influence their role; 4) anticipated barriers to intervention participation and maintenance; and 5) had concerns regarding peer coach selection. Findings are discussed in the context of the Consolidated Framework for Implementation Research. Conclusions Understanding clinician perceptions of a peer support intervention is critical for successful implementation. The feedback collected in this study will facilitate implementation of the intervention on a broader scale, allowing more patients to benefit.

Download Full-text

Peer Support for Self-Management of Chronic Pain: the Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) Trial

Journal of General Internal Medicine ◽

10.1007/s11606-020-06007-6 ◽

2020 ◽

Vol 35 (12) ◽

pp. 3525-3533

Author(s):

Marianne S. Matthias ◽

Matthew J. Bair ◽

Susan Ofner ◽

Michele Heisler ◽

Marina Kukla ◽

...

Keyword(s):

Chronic Pain ◽

Peer Support ◽

Self Management ◽

Pain Symptoms ◽

Peer Coach

Download Full-text

Facilitators and Barriers to Participation in a Peer Support Intervention for Veterans With Chronic Pain

Clinical Journal of Pain ◽

10.1097/ajp.0000000000000297 ◽

2016 ◽

Vol 32 (6) ◽

pp. 534-540 ◽

Cited By ~ 7

Author(s):

Marianne S. Matthias ◽

Marina Kukla ◽

Alan B. McGuire ◽

Teresa M. Damush ◽

Nabiha Gill ◽

...

Keyword(s):

Chronic Pain ◽

Peer Support ◽

Support Intervention ◽

Barriers To Participation ◽

Facilitators And Barriers ◽

Peer Support Intervention

Download Full-text

Evaluating Chronic Pain Self-Management Support With an Opioid De-prescribing Intervention

Case Medical Research ◽

10.31525/ct1-nct03890263 ◽

2019 ◽

Author(s):

Keyword(s):

Chronic Pain ◽

Self Management ◽

Management Support

Download Full-text

Women Veterans’ Experiences with Integrated, Biopsychosocial Pain Care: A Qualitative Study

Pain Medicine ◽

10.1093/pm/pnaa481 ◽

2021 ◽

Author(s):

Francesca M Nicosia ◽

Carolyn J Gibson ◽

Natalie Purcell ◽

Kara Zamora ◽

Jennifer Tighe ◽

...

Keyword(s):

Chronic Pain ◽

San Francisco ◽

Women Veterans ◽

Self Management ◽

Veterans Health ◽

Health Administration ◽

Care Models ◽

Va Health Care System ◽

Pain Care ◽

Gender Specific

Abstract Objectives Biopsychosocial, integrated pain care models are increasingly implemented in the Veterans Health Administration to improve chronic pain care and reduce opioid-related risks, but little is known about how well these models address women veterans’ needs. Design Qualitative, interview-based study. Setting San Francisco VA Health Care System Integrated Pain Team (IPT), an interdisciplinary team that provides short-term, personalized chronic pain care emphasizing functional goals and active self-management. Subjects Women with chronic pain who completed ≥3 IPT sessions. Methods Semistructured phone interviews focused on overall experience with IPT, perceived effectiveness of IPT care, pain care preferences, and suggested changes for improving gender-sensitive pain care. We used a rapid approach to qualitative thematic analysis to analyze interviews. Results Fourteen women veterans (mean age 51 years; range 33–67 years) completed interviews. Interviews revealed several factors impacting women veterans’ experiences: 1) an overall preference for receiving both primary and IPT care in gender-specific settings, 2) varying levels of confidence that IPT could adequately address gender-specific pain issues, 3) barriers to participating in pain groups, and 4) barriers to IPT self-management recommendations due to caregiving responsibilities. Conclusions Women veterans reported varied experiences with IPT. Recommendations to improve gender-sensitive pain care include increased provider training; increased knowledge of and sensitivity to women’s health concerns; and improved accommodations for prior trauma, family and work obligations, and geographic barriers. To better meet the needs of women veterans with chronic pain, integrated pain care models must be informed by an understanding of gender-specific needs, challenges, and preferences.

Download Full-text

Peer support program (P-SUP) to strengthen self-management in patients with chronic conditions

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1122 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Giesen ◽

H Könnecke ◽

M Redaèlli ◽

D Simic ◽

M Heßbrügge ◽

...

Keyword(s):

Peer Support ◽

Support Groups ◽

Chronic Conditions ◽

Primary Outcome ◽

Hospital Admissions ◽

Self Management ◽

Artery Disease ◽

Telephone Coaching

Abstract Background Chronic care programmes (CCPs) ensure a standardised, evidence based and structured patient care. In Germany, CCPs are successful in improving quality of care and making care more patient-centred. Regarding self-management support, however, the programs only feature patient education and shared decisions on treatment goals. Peer support has proven to be a successful component in outpatient care to enhance self-management. The aim of this study is to support patients with type 2 diabetes and coronary artery disease in conducting successful self-management through a multimodal program. Methods This randomized controlled trial (RCT) is set up for 27 months and will include a study population of approximately 1800 patients, beginning in summer 2020. The primary outcome (PO) is the reduction of hospital admissions. In addition to the PO, secondary outcomes include motivational and knowledge-based aspects. Furthermore, health-competitive and health-economic data will be collected. The formative evaluation will review the processes for implementation. The central element of the intervention will be peer support groups, in which the group will participate in physical activities and educational lectures on nutrition, exercise or disease related knowledge. Additionally, a specially designed online platform, personalized feedback for patients on medical outcomes from their family doctors, and regular telephone coaching to increase intrinsic motivation and activation will be provided. Results In addition to the primary outcome (reduction of hospital admissions), increased motivation levels, improved quality of life and increased health literacy are expected. Conclusions This project, funded by the Federal Joint Committee (establishment of statutory health insurance funds and medical providers in Germany), can serve as a blueprint for future implementations of public health approaches and accessible care models for patients with chronic conditions. Key messages Peer support as a successful method to enhance self-management in patients with type 2 diabetes and coronary artery disease. A multimodal program, consisting of peer support groups, an online platform, personalized medical feedback and telephone coaching, aiming to improve quality of life in patients with chronic conditions.

Download Full-text