(155) Personalized Activated Care and Training: A PACT with Patients to Prevent Chronic Pain and Addiction

Abstract

PURPOSE: The Institute of Medicine states that a health professionals’ primary role for chronic pain should be guiding, coaching, and assisting patients with day-to-day self-management. However, providers often lack the time and training to perform this role, and there is limited research on self-management approaches. We propose providers use a transformative care model that integrates robust patient training with evidence-based treatments using tele-coaching and technology to improve long-term outcomes and health chronic pain. METHODS: The Personalized Activated Care and Training (PACT) program was developed to enhance understanding, compliance, and success in self-management of pain conditions and includes risk assessment, on-line risk reduction training, and tele-health coaching to reduce risk factors that contribute to delayed recovery and implement protective actions to reduce chronic pain. We conducted a pilot RCT to refine the program, evaluate evaluate preliminary efficacy at 8 and 16 weeks and feasibility for broad scale implementation. RESULTS: Eighty-one subjects were randomized to PACT and Usual care and survey measures were obtained. Cohen's -d statistic was estimated for survey outcomes and a subset of participants were interviewed regarding their experiences. Participants had a mean age of 46 (PACT), 49 (TSC) and the majority were white and female. Outcomes at 16 weeks in patients with head and neck pain showed improvement in the PACT group relative to UC on measures of pain severity (PACT: 1.22, UC: -.74), pain interference in daily living (PACT: -.49, UC: -.27), and chronic pain self-efficacy (PACT: .45, UC: .27). CONCLUSION: This research demonstrated that transformative care model that includes tele-health coaching and on-line training is both feasible and effective. It provides an accessible, scalable, and transferable method for self-management that can be integrated into routine care without increasing the burden of time demands upon the providers. PACT was developed and tested with grants from NIH/NIDCRU01DE025609.