Journal article
Impact of COVID-19 pandemic on nonpharmacological pain management trials in military and veteran healthcare settings: an evaluation informed by implementation science
Translational behavioral medicine, Vol.13(8), pp.601-611
08/2023
DOI: 10.1093/tbm/ibad015
PMCID: PMC10415731
PMID: 37030012
Abstract
The coronavirus disease (COVID-19) pandemic disrupted healthcare and clinical research, including a suite of 11 pragmatic clinical trials (PCTs), across clinics within the Department of Veterans Affairs (VA) and the Department of Defense (DOD). These PCTs were designed to evaluate an array of nonpharmacological treatments and models of care for treatment of patients with pain and co-occurring conditions.
The aims of the study are to (a) describe modifications to PCTs and interventions to address the evolving pandemic and (b) describe the application of implementation science methods for evaluation of those PCT modifications.
The project used a two-phase, sequential, mixed-methods design. In Phase I, we captured PCT disruptions and modifications via a Research Electronic Data Capture questionnaire, using Periodic Reflections methods as a guide. In Phase II, we utilized the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) taxonomy to develop a focus group interview guide and checklist that would provide more in-depth data than Phase I. Data were analyzed using directed content analysis.
Phase I revealed that all PCTs made between two and six trial modifications. Phase II, FRAME-guided analyses showed that the key goals for modifying interventions were increasing treatment feasibility and decreasing patient exposure to COVID-19, while preserving intervention core elements. Context (format) modifications led eight PCTs to modify parts of the interventions for virtual delivery. Content modifications added elements to enhance patient safety; tailored interventions for virtual delivery (counseling, exercise, mindfulness); and modified interventions involving manual therapies.
Implementation science methods identified near-real-time disruptions and modifications to PCTs focused on pain management in veteran and military healthcare settings.
Details
- Title: Subtitle
- Impact of COVID-19 pandemic on nonpharmacological pain management trials in military and veteran healthcare settings: an evaluation informed by implementation science
- Creators
- Amanda M Midboe - VA Palo Alto Health Care SystemSarah J Javier - VA Palo Alto Health Care SystemStacie A Salsbury - Palmer College of ChiropracticLily Katsovich - Yale UniversityDiana J Burgess - Minneapolis VA Health Care SystemHeather A King - Durham VA Health Care SystemStephanie L Taylor - University of California, Los AngelesSteve Martino - Yale UniversityJohn M Mayer - Sport FoundationRobert B Wallace - University of IowaClaudia Der-Martirosian - Center for the Study of Healthcare Provider BehaviorRobert D Kerns - Yale University
- Resource Type
- Journal article
- Publication Details
- Translational behavioral medicine, Vol.13(8), pp.601-611
- DOI
- 10.1093/tbm/ibad015
- PMID
- 37030012
- PMCID
- PMC10415731
- NLM abbreviation
- Transl Behav Med
- eISSN
- 1613-9860
- Grant note
- DOI: 10.13039/100008460, name: National Center for Complementary and Integrative Health; DOI: 10.13039/100000118, name: Office of Behavioral and Social Sciences Research; DOI: 10.13039/100000002, name: National Institutes of Health, award: FOP 21-140
- Language
- English
- Electronic publication date
- 04/08/2023
- Date published
- 08/2023
- Academic Unit
- Epidemiology; Injury Prevention Research Center
- Record Identifier
- 9984399497602771
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