(Press-News.org) INDIANAPOLIS -- Chronic pain in the back, neck and other joints due to arthritis or other musculoskeletal disorders is extremely common but difficult to treat. In a new study published in the July 16 issue of Journal of the American Medical Association, primary-care patients enrolled in a 12-month telecare program optimizing non-opioid medications for chronic pain were twice as likely to see improvement as patients who received usual care for chronic pain.
In addition to experiencing pain improvement, patients in the telecare arm of the pain management study reported greater satisfaction with their chronic pain treatment than patients receiving usual care.
The Stepped Care to Optimize Pain care Effectiveness study, or SCOPE, was a randomized trial comparing telephone-delivered collaborative care pain management versus usual care. SCOPE enrolled 250 Richard L. Roudebush Veterans Affairs Medical Center clinic patients age 18 to 65; each participant had at least three months of chronic musculoskeletal pain of moderate or greater intensity.
"Not only were chronic pain patients who received automated symptom management and calls from a nurse two times more likely to see their pain improve; patients who didn't have this interaction were two times as likely to get worse than those who had the telecare intervention," said Kurt Kroenke, M.D., who designed and led the SCOPE study. "Our results demonstrate both the effectiveness of the telecare as well as the risk of patient deterioration in the absence of systematic approaches to optimizing pain therapy."
A research scientist with the Richard L. Roudebush VA Medical Center in Indianapolis and the Regenstrief Institute and an Indiana University School of Medicine professor of medicine, Dr. Kroenke is an internist whose research and clinical practice focus on symptom management.
Both men and women were equally likely to benefit from telecare in the SCOPE study. The benefit did not vary by the age or race of the study participant. Although one-third of patients were on opioid therapy before the yearlong study began, few patients (4 percent) were prescribed opioids for the first time or had escalations in opioid dosage.
"Relieving Pain in America," a 2011 report from the Institute of Medicine, highlights the enormous functional and economic impact of musculoskeletal pain. According to the IOM report, pain is a leading cause of work disability and costs the United States more than $600 billion annually in health care and lost productivity.
SCOPE telecare was delivered in collaboration with the study participants' primary-care physician via two avenues.
Automated symptom monitoring -- either by interactive voice-recorded phone calls (selected by 51 percent of intervention patients) or over the Internet (selected by 49 percent) -- was scheduled weekly for the first month, every other week for months two and three, and monthly for month four through 12.
Pain management focusing on the use of non-opioid therapies by a nurse care manager/physician pain specialist team was provided throughout the course of the study. Non-opioid therapies included five categories of non-addictive pain relievers.
Unlike his previous studies of depression patients that showed rapid initial improvement with telecare, Dr. Kroenke found in the SCOPE study that for chronic pain, improvement was gradual over the year. He notes that patience by patients, families and physicians is required to see reduction in chronic pain.
INFORMATION:
Authors of the study in addition to Dr. Kroenke are Erin E. Krebs, M.D., of the Minneapolis VA Health Care System and University of Minnesota Medical School; Jingwei Wu, M.S., and Zhangsheng Yu, Ph.D., of the IU Department of Biostatistics; Neale R. Chumbler, Ph.D., of the College of Public Health, University of Georgia; and Matthew J. Bair, M.D., of the Roudebush VA Medical Center, the Regenstrief Institute and the IU School of Medicine.
The SCOPE study was supported by a Department of Veterans Affairs Health Services Research and Development Merit Review award to Dr. Kroenke (IIR 07-119) and Career Development Award to Dr. Krebs (CDA 07-215). The views expressed in the study are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
JAMA study: Telecare program optimizing non-opioid chronic pain medication very effective
2014-07-15
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
Do daughters really cause divorce? Maybe not
2014-07-15
DURHAM, N.C. -- In the U.S., couples with daughters are somewhat more likely to divorce than couples with sons. Many scholars have read those numbers as evidence that daughters cause divorce.
But new research from Duke University suggests something quite different may be at play: Girls may be hardier than boys, even in the womb, and may be better able to survive pregnancies stressed by a troubled marriage.
Previous studies have argued that fathers prefer boys and are more likely to stay in marriages that produce sons. Conversely, the argument runs, men are more likely ...
Gene discovery could lead to better soybean varieties for Northern United States
2014-07-15
WEST LAFAYETTE, Ind. – Researchers from Purdue University and the University of Nebraska-Lincoln have discovered a soybean gene whose mutation affects plant stem growth, a finding that could lead to the development of improved soybean cultivars for the northern United States.
Purdue agronomy professor Jianxin Ma (pronounced Jen-SHIN' Ma) and collaborators identified a gene known as Dt2, which causes semideterminacy in soybean plants. Semideterminate soybean plants - mid-size plants that continue vegetative growth even after flowering - can produce as many or more pods ...
Transparency lacking in clinical trials, BU study finds
2014-07-15
A significant percentage of completed drug clinical trials, especially those funded by industry, are not disclosed to the public, years after being completed—a trend that "threatens the validity of the clinical research literature in the U.S.," according to a study led by a Boston University School of Public Health (BUSPH) researcher.
The study, published in the journal PLOS ONE, found that close to 30 percent of 400 randomly selected clinical trials completed in 2008 had not resulted, four years later, in either publication in a journal or the posting of results to the ...
Do women talk more than men? It's all about context
2014-07-15
We've all heard the stereotype: Women like to talk. We bounce ideas off each other about everything from career moves to dinner plans. We hash out big decisions through our conversations with one another and work through our emotions with discussion.
At least, that's what "they" say. But is any of it actually true? A new study from Northeastern University professor David Lazer's lab says it isn't that simple.
Lazer, who researches social networks and holds joint appointments in the Department of Political Science and the College of Computer and Information Sciences, ...
NASA's Van Allen Probes show how to accelerate electrons
2014-07-15
One of the great, unanswered questions for space weather scientists is just what creates two gigantic donuts of radiation surrounding Earth, called the Van Allen radiation belts. Recent data from the Van Allen Probes -- two nearly identical spacecraft that launched in 2012 -- address this question.
The inner Van Allen radiation belt is fairly stable, but the outer one changes shape, size and composition in ways that scientists don't yet perfectly understand. Some of the particles within this belt zoom along at close to light speed, but just what accelerates these particles ...
NOAA's GOES-R satellite Magnetometer ready for spacecraft integration
2014-07-15
The Magnetometer instrument that will fly on NOAA's GOES-R satellite when it is launched in early 2016 has completed the development and testing phase and is ready to be integrated with the spacecraft.
The Magnetometer will monitor magnetic field variations around the Earth and enable forecasters at NOAA's Space Weather Prediction Center to better predict the consequences of geomagnetic storms. These storms pose a threat to orbiting spacecraft and human spaceflight. In addition, the measurements taken by the Magnetometer will aid in providing alerts and warnings to power ...
For bees and flowers, tongue size matters
2014-07-15
For bees and the flowers they pollinate, a compatible tongue length is essential to a successful relationship. Some bees and plants are very closely matched, with bee tongue sized to the flower depth. Other bee species are generalists, flitting among flower species to drink nectar and collect pollen from a diverse variety of plants. Data on tongue lengths can help ecologists understand and predict the behavior, resilience and invasiveness of bee populations.
But bee tongues are hard to measure. The scarcity of reliable lingual datasets has held back research, so Ignasi ...
Study finds why some firms are 'named and shamed' by activists
2014-07-15
COLUMBUS, Ohio – A new study of the anti-sweatshop campaigns of the 1990s reveals which companies are most likely to become targets of anti-corporate activists.
Researchers found that companies tended to attract the attention of labor activists if they were large, had prominent brand images, or had good corporate reputations. When combined, these factors were especially important.
"Companies that had all of these characteristics were nearly guaranteed to be a target of activism," said Tim Bartley, lead author of the study and associate professor of sociology at The ...
Fundamental chemistry findings could help extend Moore's Law
2014-07-15
Over the years, computer chips have gotten smaller thanks to advances in materials science and manufacturing technologies. This march of progress, the doubling of transistors on a microprocessor roughly every two years, is called Moore's Law. But there's one component of the chip-making process in need of an overhaul if Moore's law is to continue: the chemical mixture called photoresist. Similar to film used in photography, photoresist, also just called resist, is used to lay down the patterns of ever-shrinking lines and features on a chip.
Now, in a bid to continue decreasing ...
Study: Body Dysmorphic Disorder patients have higher risk of personal and appearance-based rejection sensitivity
2014-07-15
PROVIDENCE, R.I. – In a recent study, researchers at Rhode Island Hospital found that fear of being rejected because of one's appearance, as well as rejection sensitivity to general interpersonal situations, were significantly elevated in individuals with Body Dysmorphic Disorder (BDD). These fears, referred to as personal rejection sensitivity and appearance-based rejection sensitivity, can lead to diminished quality of life and poorer mental and overall health. BDD is a common, often severe, and under-recognized body image disorder that affects an estimated 1.7 to 2.4 ...