TY - JOUR
AU - T. I. Lovejoy
AU - T . Y. Wu
AU - P. Maloy
AU - S. M. McPherson
AU - C. L. Smith
AU - B. Zaccari
A1 - 
AB - PURPOSE: Little is known about the use of collaborative care models for patients with co-occurring chronic pain and substance use disorders (SUD). This study aimed to pilot test a collaborative care intervention delivered over telehealth to rural patients engaged with SUD treatment who experienced chronic pain. DESIGN: Single-arm, open-label pilot intervention trial. METHODS: Patients (N=88) were enrolled in SUD treatment at a single VA Medical Center and endorsed moderate-to-severe chronic pain. Patients received a nurse-led collaborative care intervention consisting of a comprehensive pain assessment, up to six follow-up appointments with the nurse care manager (NCM), and an optional 10-session pain education class. All patient encounters occurred remotely via telehealth. Baseline, 1- and 4-month follow up assessments measured outcomes of pain, depression, and substance use. Generalized estimating equations and intent-to-treat procedures modelled changes in outcomes over time. RESULTS: Patients were predominantly male (85%) and white (85%), with high mental health and substance use disorder comorbidities (92%). The most common substances of use at treatment initiation were alcohol (49%), opioids (17%), cannabis (17%), methamphetamine (11%), and cocaine (6%). By 4-month follow-up, patients who received the pain intervention endorsed significant reductions in pain intensity, pain interference, and depressive symptoms. Among patients using alcohol or cannabis at baseline, significant reductions in days using these substances were also observed. CONCLUSIONS AND CLINICAL IMPLICATIONS: An NCM-led collaborative care intervention delivered via telehealth may improve both pain and substance use outcomes for rural patients with these comorbidities. Large-scale clinical trials are needed to demonstrate intervention efficacy.
AD - VHA Office of Rural Health, Veterans Rural Health Resource Center, Portland, OR; Department of Psychiatry, Oregon Health & Science University, Portland, OR; Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR. Electronic address: travis.lovejoy@va.gov.; Department of Psychiatry, Oregon Health & Science University, Portland, OR; Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.; Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.; Elson S. Floyd College of Medicine, Washington State University, Spokane, WA.
AN - 39890565
BT - Pain Manag Nurs
C5 - Healthcare Disparities; HIT & Telehealth; Opioids & Substance Use
CP - 3
DA - Jun
DO - 10.1016/j.pmn.2024.12.020
DP - NLM
ET - 20250130
IS - 3
JF - Pain Manag Nurs
LA - eng
N2 - PURPOSE: Little is known about the use of collaborative care models for patients with co-occurring chronic pain and substance use disorders (SUD). This study aimed to pilot test a collaborative care intervention delivered over telehealth to rural patients engaged with SUD treatment who experienced chronic pain. DESIGN: Single-arm, open-label pilot intervention trial. METHODS: Patients (N=88) were enrolled in SUD treatment at a single VA Medical Center and endorsed moderate-to-severe chronic pain. Patients received a nurse-led collaborative care intervention consisting of a comprehensive pain assessment, up to six follow-up appointments with the nurse care manager (NCM), and an optional 10-session pain education class. All patient encounters occurred remotely via telehealth. Baseline, 1- and 4-month follow up assessments measured outcomes of pain, depression, and substance use. Generalized estimating equations and intent-to-treat procedures modelled changes in outcomes over time. RESULTS: Patients were predominantly male (85%) and white (85%), with high mental health and substance use disorder comorbidities (92%). The most common substances of use at treatment initiation were alcohol (49%), opioids (17%), cannabis (17%), methamphetamine (11%), and cocaine (6%). By 4-month follow-up, patients who received the pain intervention endorsed significant reductions in pain intensity, pain interference, and depressive symptoms. Among patients using alcohol or cannabis at baseline, significant reductions in days using these substances were also observed. CONCLUSIONS AND CLINICAL IMPLICATIONS: An NCM-led collaborative care intervention delivered via telehealth may improve both pain and substance use outcomes for rural patients with these comorbidities. Large-scale clinical trials are needed to demonstrate intervention efficacy.
PY - 2025
SN - 1524-9042
SP - 264
EP - 270+
ST - Collaborative Tele-Pain and Substance Use Disorder Care for Patients in a Rural Setting: Results of a Single-Arm Open-Label Pilot Trial
T1 - Collaborative Tele-Pain and Substance Use Disorder Care for Patients in a Rural Setting: Results of a Single-Arm Open-Label Pilot Trial
T2 - Pain Manag Nurs
TI - Collaborative Tele-Pain and Substance Use Disorder Care for Patients in a Rural Setting: Results of a Single-Arm Open-Label Pilot Trial
U1 - Healthcare Disparities; HIT & Telehealth; Opioids & Substance Use
U3 - 10.1016/j.pmn.2024.12.020
VL - 26
VO - 1524-9042
Y1 - 2025
ER -