Comprehensive Opioid Management in Patient Aligned Care Teams (COMPACT)
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ClinicalTrials.gov Identifier: NCT01737073 |
Recruitment Status :
Withdrawn
(This study was unable to overcome IT and contracting barriers which prevented the study's data collection system from being implemented.)
First Posted : November 29, 2012
Last Update Posted : March 7, 2019
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Condition or disease | Intervention/treatment | Phase |
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Chronic Pain | Behavioral: IVR self-management Behavioral: Opioid monitoring Other: Enhanced usual care | Not Applicable |
The objectives of the study are to: 1) test the effectiveness of an automated intervention system called COMPACT for improving pain-relevant outcomes including physical functioning and pain intensity; 2) determine whether opioid monitoring promotes guideline concordant care; and 3) examine key components of the intervention process to inform future implementation.
This study is a randomized, controlled, multi-site, factorial design trial of a technology supported treatment program called COMPACT relative to enhanced usual care (EUC) in the PACT setting. Participants will include 380 Veterans receiving chronic opioid therapy (COT) and reporting chronic musculoskeletal pain of at least moderate severity. Outcomes of interest include pain-related physical functioning, pain intensity, presence of guideline concordant care practices, and provider satisfaction. Enrolled participants will be randomized to receive COMPACT treatment or EUC. At baseline, 12 weeks (post-treatment), 24 weeks (follow-up) and 36 weeks (follow-up) all participants will undergo an opioid risk evaluation and assessment of all outcome variables. Participants randomized to COMPACT treatment will received interactive voice response (IVR)-based pain self management training and monthly opioid risk monitoring. Throughout treatment COMPACT participants will undergo automated monthly opioid risk monitoring and collection of patient reported opioid use, pain intensity, physical functioning, emotional functioning and quality of life data. Monthly opioid risk monitoring information will be made available to PACT clinicians via automatic entry into CPRS prior to a scheduled opioid renewal appointment. Participants in the EUC condition will undergo assessment of outcome variables and opioid risk assessment at 12-, 24- and 36-weeks post baseline only; they will not receive treatment or opioid monitoring.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 0 participants |
Allocation: | Randomized |
Intervention Model: | Factorial Assignment |
Masking: | Single (Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Comprehensive Opioid Management in Patient Aligned Care Teams (COMPACT) |
Actual Study Start Date : | April 1, 2017 |
Actual Primary Completion Date : | April 1, 2017 |
Actual Study Completion Date : | April 1, 2017 |
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Arm | Intervention/treatment |
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Experimental: IVR self management
cognitive behavioral based self management training for chronic pain delivered by interactive voice response (IVR)
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Behavioral: IVR self-management
A course of self-management training that includes 12 education and self-management skill modules presented over 12 consecutive weeks. Participants will be asked to practice each skill daily and report via IVR on their completion of the daily skill practice. They will receive a 10 minute call each week from a nurse care manager to discuss their weekly progress. |
Experimental: Opioid monitoring
monthly interactive voice response (IVR) monitoring of prescription opioid use with feedback to the prescribing physician
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Behavioral: Opioid monitoring
Monthly automated monitoring of prescription opioid use including pain relief, physical activity, pain-related interference, mood, adverse effects, adherence and satisfaction with treatment. |
Experimental: IVR self management plus opioid monitoring
Cognitive behavioral based self management training for chronic pain delivered by IVR plus monthly IVR monitoring of prescription opioid use with feedback to the prescribing physician
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Behavioral: IVR self-management
A course of self-management training that includes 12 education and self-management skill modules presented over 12 consecutive weeks. Participants will be asked to practice each skill daily and report via IVR on their completion of the daily skill practice. They will receive a 10 minute call each week from a nurse care manager to discuss their weekly progress. Behavioral: Opioid monitoring Monthly automated monitoring of prescription opioid use including pain relief, physical activity, pain-related interference, mood, adverse effects, adherence and satisfaction with treatment. |
Enhanced usual care
Weekly automated wellness tips via IVR
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Other: Enhanced usual care
Weekly automated wellness tip and usual clinical care |
- Brief Pain Inventory [ Time Frame: Post-treatment (12 weeks post baseline) ]
- Concordance with opioid treatment practice guidelines [ Time Frame: Post-treatment ]Evaluation of the effect of the OM intervention on providers' concordance with VA/DoD chronic opioid treatment practice guidelines will be a quality score (scale 0 - 8) that represents the number of practices out of eight key practices to which providers adhered at the 12 weeks follow up. The eight key practices considered are: use of UDS, contra-indicated co-prescription, non-medication treatments, no psychiatric at risk/SUD, acetaminophen over-prescription, risky sedative co-prescription, bowel regimen and serious adverse effects
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
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presence of at least moderate musculoskeletal diagnosis pain (i.e., pain scores of 4 as measured by the Numeric Rating Scale) for a period of 3 months. Musculoskeletal diagnosis is a cluster of disorders including:
- low back and spine conditions
- osteoarthritis
- nerve compression
- other inflammatory and degenerative disorders
- receipt of chronic opioid therapy [90 continuous days out of any 104 day period in the prior 12 month]
- ability to participate safely in the walking portion of the intervention as evidenced by patient-reported ability to walk at one block
- availability of a land line or cellular telephone
Exclusion Criteria:
- active psychosis or suicidality that could impair participation, identified using validated measures in the baseline screener
- life threatening or acute medical condition that could impair participation
- dementia defined by a score of 20 or greater on the St. Louis University Mental Status in the baseline screener
- any sensory deficits that would impair participation (e.g., hearing loss to a degree that telephone usage is not possible)
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To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01737073
United States, Indiana | |
Richard L. Roudebush VA Medical Center, Indianapolis, IN | |
Indianapolis, Indiana, United States, 46202-2884 | |
United States, Michigan | |
VA Ann Arbor Healthcare System, Ann Arbor, MI | |
Ann Arbor, Michigan, United States, 48105 |
Principal Investigator: | Alicia A. Heapy, PhD | VA Connecticut Healthcare System West Haven Campus, West Haven, CT |
Responsible Party: | VA Office of Research and Development |
ClinicalTrials.gov Identifier: | NCT01737073 |
Obsolete Identifiers: | NCT02508285 |
Other Study ID Numbers: |
CRE 12-006 |
First Posted: | November 29, 2012 Key Record Dates |
Last Update Posted: | March 7, 2019 |
Last Verified: | March 2019 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | No |
chronic pain opioid cognitive behavior therapy |
Chronic Pain Pain Neurologic Manifestations Analgesics, Opioid Narcotics |
Central Nervous System Depressants Physiological Effects of Drugs Analgesics Sensory System Agents Peripheral Nervous System Agents |