Date of Award

Spring 2020

Degree Type

Thesis

Department

Health Promotion, Education and Behavior

Director of Thesis

Jim Burch, MS, PhD

Second Reader

Deborah Reyes, PhD

Abstract

Chronic pain is a prevalent issue amongst US veterans. Experts suggest that interdisciplinary pain treatment is the most effective method of treating chronic pain, specifically due to targeting functioning and quality of life. These programs combine cognitive behavioral therapy and physical therapy by utilizing a variety of exercise and education regimens. The pain department at Columbia VA Health Care System offers both a comprehensive interdisciplinary treatment, Outpatient Interdisciplinary Pain Program (OIPP), and a flexible, multidisciplinary option (OIPP-Lite) for veterans suffering from chronic pain. The goal of this program is to improve knowledge for coping with chronic pain and to create a better quality of life in regard to both physical and mental health. This study was designed to examine the effectiveness of the programs. Although the multidisciplinary program (OIPP-Lite) offers flexibility and is less taxing on veteran and administration resources, preliminary examination would suggest that the interdisciplinary approach (OIPP) offers more effective treatment. Data collection included behavioral health measures, physical therapy measures, knowledge gains, and patient histories to determine changes in the amount of pain-related medical visits. These measures were conducted upon program entry, program completion, and 3- and 6-month follow up appointments. Data was then analyzed by comparing the initial measures between both OIPP and OIPP-Lite and then comparison between post-OIPP measures, 3-month, and 6-month follow ups. Statistical testing was conducted by using a t-test to compare between the separate data groups, leading to the determination that the group composition of initial measures for each program are relatively comparable. Veterans were given the option to participate in either OIPP or OIPP-Lite based on personal preference. For the purpose of this study, 112 participants of both OIPP and OIPP-Lite were analyzed. Due to difference in program duration, there were twice as many OIPP cohorts compared to OIPP-Lite. Common age groups included the age ranges of 41-65 and 66-85, with 86% of participants being males. The common diagnoses of participants included back, arm/leg, and neck pain, depression, and insomnia. It was hypothesized that an interdisciplinary program (OIPP) would produce more effective gains in quality of life and physical gains than a multidisciplinary approach (OIPP-Lite). While both see general positive growth in scores, OIPP had larger improvements on average despite having worse initial symptoms. Both programs demonstrated significant increase in veterans’ knowledge of pain management and improvements in pain catastrophizing, depression, and the number of pain-related medical visits. Only OIPP revealed significant improvements in sleep hygiene. However, OIPP-Lite utilizes fewer VA resources and is more efficient to offer to participants. Additional information concerning veteran satisfaction is desired to create a conclusive choice between OIPP and OIPP-Lite. It is recommended for VHA to consider continuing both programs to effectively address the needs and preferences of the veterans served.

First Page

1

Last Page

29

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