Adapting to disruption of research during the COVID-19 pandemic while testing nonpharmacological approaches to pain management

Abstract

The COVID-19 pandemic has slowed research progress, with particularly disruptive effects on investigations of addressing urgent public health challenges, such as chronic pain. The National Institutes of Health (NIH) Department of Defense (DoD) Department of Veterans Affairs (VA) Pain Management Collaboratory (PMC) supports 11 large-scale, multisite, embedded pragmatic clinical trials (PCTs) in military and veteran health systems. The PMC rapidly developed and enacted a plan to address key issues in response to the COVID-19 pandemic. The PMC tracked and collaborated in developing plans for addressing COVID-19 impacts across multiple domains and characterized the impact of COVID-19 on PCT operations, including delays in recruitment and revisions of study protocols. A harmonized participant questionnaire will facilitate later meta-analyses and cross-study comparisons of the impact of COVID-19 across all 11 PCTs. The pandemic has affected intervention delivery, outcomes, regulatory and ethics issues, participant recruitment, and study design. The PMC took concrete steps to ensure scientific rigor while encouraging flexibility in the PCTs, while paying close attention to minimizing the burden on research participants, investigators, and clinical care teams. Sudden changes in the delivery of pain management interventions will probably alter treatment effects measured via PMC PCTs. Through the use of harmonized instruments and surveys, we are capturing these changes and plan to monitor the impact on research practices, as well as on health outcomes. Analyses of patient-reported measures over time will inform potential relationships between chronic pain, mental health, and various socioeconomic stressors common among Americans during the COVID-19 pandemic.

Climate Donations Inspired by Evidence-Based Fundraising

“…However, the university at which participants were recruited was closed due to the COVID-19 pandemic in between experimental sessions. Indeed, many members of the research community have had to reconsider study design and adjust expectations for this reason ( Barroga and Matanguihan, 2020 ; Coleman et al, 2020 ). The small sample size increases the risk of overinterpreting the data, particularly given the interaction effects and inclusion of three PCs.…”

Pain coping skills training un-locks patient-centered pain care during the COVID- 19 lockdown

“…Additional barriers may exist at different points in time. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID -19 pandemic impacted the healthcare system in the northeast in the spring of 2020 (Coleman et al, 2020). The convergence of the pandemic and epidemic of chronic pain has further challenged communities, healthcare providers, and healthcare systems.…”

“…COVID-19 caused an insurmountable impact, especially detrimental to marginalized communities, such as individuals who suffer from chronic pain. During and beyond the COVID-19 pandemic, shifts in care delivery have widened the disparity gap in the undertreatment of pain in this at-risk population (Coleman et al, 2020). In addition, state and national authorities expect adverse consequences related to social isolation and inadequate provider interaction for patients Pain coping skills COVID-19 with chronic pain (Puntillo et al,2020).…”

Changes in the Use of Telehealth and Face-To-Face Chiropractic Care in the Department of Veterans Affairs Before and After the COVID-19 Pandemic

“…Yet several ongoing studies assessing the treatment of chronic pain by nonpharmacological methodsincluding chiropractic carehave adopted virtual care delivery. 45,46 Future work in the VHA should assess clinical and sociodemographic characteristics of patients receiving chiropractic care via telehealth, as well as the services delivered in such visits.…”