Marc I Rosen1,2, William C Becker2,3, Anne C Black1,2, Steve Martino1,2, Ellen L Edens1,2, Robert D Kerns1,2. 1. Department of Psychiatry, Yale University, New Haven, Connecticut. 2. VA Connecticut Healthcare System, West Haven, Connecticut. 3. Section of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Abstract
OBJECTIVE: High proportions of post-9/11 veterans have musculoskeletal disorders (MSDs), but engaging them in care early in their course of illness has been challenging. The service connection application is an ideal point of contact for referring veterans to early interventions for their conditions. DESIGN: Among MSD claimants who reported risky substance use, we pilot-tested a counseling intervention targeting pain and risky substance use called Screening Brief Intervention and Referral to Treatment-Pain Module (SBIRT-PM). Veterans were randomly assigned in a 2:1:1 ratio to SBIRT-PM, Pain Module counseling only, or treatment as usual (TAU). METHODS: Participants assigned to either counseling arm were offered a single meeting with a study therapist with two follow-up telephone calls as needed. Participants completed outcome assessments at four and 12 weeks after randomization. RESULTS:Of 257 veterans evaluated, 101 reported risky substance use and were randomized. Counseling was attended by 75% of veterans offered it and was well received. VA pain-related services were used by 51% of participants in either of the pain-focused conditions but only by 27% in TAU (P < 0.04). Starting with average pain severity ratings of 5.1/10 at baseline, only minimal changes in mean pain severity were noted regardless of condition. Self-reported risky substance use was significantly lower over time in the SBIRT-PM condition relative to the two other conditions (P < 0.02). At week 12, proportions of veterans reporting risky substance use were 0.39, 0.69, and 0.71 for the SBIRT-PM, Pain Module counseling, and TAU conditions, respectively. CONCLUSIONS: SBIRT-PM shows promise as a way to engage veterans in pain treatment and reduce substance use.
RCT Entities:
OBJECTIVE: High proportions of post-9/11 veterans have musculoskeletal disorders (MSDs), but engaging them in care early in their course of illness has been challenging. The service connection application is an ideal point of contact for referring veterans to early interventions for their conditions. DESIGN: Among MSD claimants who reported risky substance use, we pilot-tested a counseling intervention targeting pain and risky substance use called Screening Brief Intervention and Referral to Treatment-Pain Module (SBIRT-PM). Veterans were randomly assigned in a 2:1:1 ratio to SBIRT-PM, Pain Module counseling only, or treatment as usual (TAU). METHODS:Participants assigned to either counseling arm were offered a single meeting with a study therapist with two follow-up telephone calls as needed. Participants completed outcome assessments at four and 12 weeks after randomization. RESULTS: Of 257 veterans evaluated, 101 reported risky substance use and were randomized. Counseling was attended by 75% of veterans offered it and was well received. VA pain-related services were used by 51% of participants in either of the pain-focused conditions but only by 27% in TAU (P < 0.04). Starting with average pain severity ratings of 5.1/10 at baseline, only minimal changes in mean pain severity were noted regardless of condition. Self-reported risky substance use was significantly lower over time in the SBIRT-PM condition relative to the two other conditions (P < 0.02). At week 12, proportions of veterans reporting risky substance use were 0.39, 0.69, and 0.71 for the SBIRT-PM, Pain Module counseling, and TAU conditions, respectively. CONCLUSIONS: SBIRT-PM shows promise as a way to engage veterans in pain treatment and reduce substance use.
Authors: Suzanne Spinola; Brenda T Fenton; Sarah Meshberg-Cohen; Anne C Black; Marc I Rosen Journal: Medicine (Baltimore) Date: 2021-09-03 Impact factor: 1.817
Authors: John J Sellinger; Steve Martino; Christina Lazar; Kristin Mattocks; Kenneth Rando; Kristin Serowik; Karen Ablondi; Brenda Fenton; Kathryn Gilstad-Hayden; Bradley Brummett; Paul E Holtzheimer; Diana Higgins; Thomas E Reznik; Alicia M Semiatin; Todd Stapley; Tu Ngo; Marc I Rosen Journal: Pain Pract Date: 2021-06-26 Impact factor: 3.079
Authors: Steve Martino; Christina Lazar; John Sellinger; Kathryn Gilstad-Hayden; Brenda Fenton; Paul G Barnett; Brad R Brummett; Diana M Higgins; Paul Holtzheimer; Kristin Mattocks; Tu Ngo; Thomas E Reznik; Alicia M Semiatin; Todd Stapley; Marc I Rosen Journal: Pain Med Date: 2020-12-12 Impact factor: 3.750