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US Military “Stepped-Care Approach” to Chronic Pain Improves Function
A two-step strategy to managing chronic pain in US military veterans was associated with improved function and decreased pain severity, yielding a 30% improvement in pain-related disability, a new study shows.
Step 1 included 12 weeks of analgesic treatment and optimization according to an algorithm, coupled with pain self-management strategies. Step 2 comprised 12 weeks of cognitive-behavioral therapy. All components of the intervention were delivered by trained nurse care managers.
Many veterans experience significant long-term pain, and medications alone are “only modestly successful in helping them; current pain treatments haven’t made much of a dent,” study chief Matthew Bair, MD, from the Richard L. Roudebush Veterans Affairs [VA] Medical Center in Indianapolis, the Regenstrief Institute, and the Indiana University School of Medicine, notes in a statement.
The decrease in pain severity and 30% improvement in pain-related disability achieved in the Evaluation of Stepped Care for Chronic Pain (ESCAPE) study are “clinically significant, and we found that improvement lasted for at least nine months,” adds Dr Bair, an internist who treats veterans in primary care and previously served for 8 years as a US Army physician.
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