Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE): Rationale, study design, methods, and sample characteristics

Matthias, Marianne S.; Adams, Jasma; Burgess, Diana J.; Daggy, Joanne; Eliacin, Johanne; Flores, Perla; Hirsh, Adam T.; Myers, Laura J.; Perkins, Anthony J.; Menen, Tetla; Procento, Philip; Rand, Kevin L.; Salyers, Michelle P.; Shanahan, Mackenzie L.

doi:10.1016/j.cct.2022.106790

Cited by 8 publications

(4 citation statements)

References 63 publications

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“…A detailed description of the COOPERATE intervention (Clinicaltrials.gov, NCT03562793) and protocol has been previously published. 45,46 COOPERATE compared a 6session coaching intervention to an attention control arm.…”

Section: Methodsmentioning

confidence: 99%

Communication and activation in pain to enhance relationships and treat pain with equity (COOPERATE): a randomized clinical trial

Matthias,

Daggy,

Perkins

et al. 2023

Pain

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Racialized disparities in chronic pain care are well-documented and persist despite national priorities focused on health equity. Similar disparities have been observed in patient activation (ie, having the knowledge, confidence, and skills to manage one's health). As such, interventions targeting patient activation represent a novel approach to addressing and reducing disparities in pain care. Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity is a randomized controlled trial of a 6-session telephone-delivered intervention to increase patient activation for Black patients with chronic pain. Two hundred fifty Black patients from a Midwestern Veterans Affairs medical center were randomized to the intervention or attention control. The primary outcome was patient activation; secondary outcomes included communication self-efficacy, pain, and psychological functioning. Outcomes were assessed at baseline and at 3 (primary endpoint), 6, and 9 months (sustained effects). Analyses used an intent-to-treat approach. Compared with baseline, patient activation increased 4.6 points at 3 months (versus +0.13 in control group, 95% CI: 0.48, 7.34; P = 0.03). These improvements in the intervention group were sustained, with +7 from baseline at 6 months and +5.77 at 9 months, and remained statistically significant from the control group. Communication self-efficacy increased significantly relative to the control group from baseline to 3 months. Pain intensity and interference improved at 3 months, but differences were not significant after adjusting for multiple comparisons. Most other secondary outcomes improved, but group differences were not statistically significant after controlling for multiple comparisons. Results suggest that increasing patient activation is a potentially fruitful path toward improving pain management and achieving health equity.

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Section: Methodsmentioning

confidence: 99%

Communication and activation in pain to enhance relationships and treat pain with equity (COOPERATE): a randomized clinical trial

Matthias,

Daggy,

Perkins

et al. 2023

Pain

Self Cite

View full text Add to dashboard Cite

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“…Details of this study are published elsewhere. 12 To be eligible to participate in COOPERATE, patients had to identify as Black or African American and have musculoskeletal pain in the low back, cervical spine, or extremities (hip, knee, shoulder) for at least 3 months. Only those who had completed the COOPERATE study at the time of recruitment (n=110) were eligible for participation, to avoid any influence of this sub-study on the parent study.…”

Section: Methodsmentioning

confidence: 99%

Healthcare Access and Delivery During the COVID-19 Pandemic for Black Veterans with Chronic Pain: a Qualitative Study

2022

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BACKGROUND:The COVID-19 pandemic led to significant disruptions in healthcare and rapid increases in virtual healthcare delivery. The full effects of these shifts remain unknown. Understanding effects of these disruptions is particularly relevant for patients with chronic pain, which typically requires consistent engagement in treatment to maximize benefit, and for Black patients, given documented racial disparities in pain treatment and telehealth delivery. OBJECTIVE: To understand how Black patients with chronic pain experienced pandemic-related changes in healthcare delivery. DESIGN: In-depth, semi-structured qualitative interviews PARTICIPANTS: Black veterans with chronic pain. KEY RESULTS: Participants described decreased ability to self-manage their chronic pain, obtain nonpharmacological services such as physical therapy, see their primary care providers, and schedule surgery. Most did not believe telehealth met their needs, describing feeling inadequately assessed for their pain and noting that beyond renewing prescriptions, telehealth visits were not that useful. Some believed their communication with their providers suffered from a lack of in-person contact. Others, however, were willing to accept this tradeoff to prevent possible exposure to COVID-19, and some appreciated the convenience of being able to access healthcare from home. CONCLUSIONS: Black patients with chronic pain described mostly negative effects from the shift to telecare after the pandemic's onset. Given existing disparities and likely persistence of virtual care, research on the longerterm effects of virtual pain care for Black patients is needed.

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“…The randomized clinical trial COOPERATE (Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity) study authored by Matthias et al 11 addresses the role of enhanced communication with patients to improve health outcomes and health equity. Specifically, it adds to our knowledge on the effectiveness of multimessaging communication as a modality to promote patient activation in Black veterans and as a mechanism to enhance pain management in this population.…”

mentioning

confidence: 99%

“…However, the results presented by Mathias et al 11 need to be carefully interpreted, and several issues clarified to determine the usefulness of enhanced phone messaging. Of particular, import is considering why the benefits of multimessaging were not sustained in reducing pain intensity and communication self-efficacy.…”

mentioning

confidence: 99%

Improving the art and science of communication in people living with chronic pain

Green

2023

Pain

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Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE): Rationale, study design, methods, and sample characteristics

Cited by 8 publications

References 63 publications

Communication and activation in pain to enhance relationships and treat pain with equity (COOPERATE): a randomized clinical trial

Communication and activation in pain to enhance relationships and treat pain with equity (COOPERATE): a randomized clinical trial

Healthcare Access and Delivery During the COVID-19 Pandemic for Black Veterans with Chronic Pain: a Qualitative Study

Improving the art and science of communication in people living with chronic pain

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