Chronic Pain Clinical Trial
Official title:
An Observational Study of Integrated Chronic Pain Management in a Community Health Center
This was a prospective observational study with the primary objective of quantifying a change in pain scores after 6-12 months of two separate interventions within the study site (pain team and chiropractic team). Target enrollment was 30 participants for each intervention. The primary outcome was a change from baseline of the Pain Disability Questionnaire (PDQ), the study tool. Secondary outcomes were reduction of opioid dose by morphine equivalent daily dose, and its effect on PDQ scores.
Data collection After participants were enrolled, they completed a baseline PDQ while waiting
for their appointment. Participants continued to see the intervention group, PCP, and other
medical providers as determined by their health providers independent of this study's
protocol. Another PDQ was collected at an intended 6 - 12 months later. Demographic
information was collected by manual chart review in the electronic medical record NextGen
(NextGen EHR, Nextgen Healthcare, Inc. Irvine, CA, USA).
Variables collected included age, sex, race, BMI, insurance type, preferred language,
presence of another pain diagnosis (e.g. knee pain), active mental health diagnosis
(including substance abuse), diagnosis of hypertension or diabetes, and morphine equivalent
dose (MED); one post-hoc variable was recorded: timing of follow-up survey in relation to the
2019 coronavirus (COVID-19) pandemic, defined as before/after March 1, 2020. Intervention
type was analyzed as an independent variable since the study was not designed as a comparison
of interventions. All data was stored in an encrypted Excel database on a password-protected
laptop. Consent forms were stored in a locked cabinet accessible only to the PI.
Stata 16.0 (StataCorp, LLC, College Station, TX, USA) was used for statistical analysis. PDQ
scores at baseline and follow-up were tested for statistical significance using paired
t-tests. Univariate analysis was performed on individual categorical variables and change in
PDQ using two-sample t-tests. Multivariate linear regression was used to determine
associations of these factors to the outcome. Variables were excluded from regression models
if there was a subgroup size of six or less.
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