Based on input of rural, largely Hispanic persons with chronic pain, a low literacy, 6-month self-management program was developed drawing upon elements of existing pain toolkits. In a randomized trial, low-income, primarily Hispanic patients with chronic pain received the program in 6 one-on-one meetings with a trained health educator in clinic or in 8 group lectures by experts in the community. Intention-to-treat (ITT) analyses in linear mixed effects models were conducted for five secondary outcomes at 6-months including: Brief Pain Inventory (BPI) pain severity and interference, Patient Health Questionnaire-9 (PHQ-9), 12-Item Short Form Survey Mental Component Summary (SF-12 MCS) and Tampa Scale for Kinesiophobia-11 (TSK-11). 111 participants were randomized (15.9% of 700 initially eligible from 3 clinics) and 67 (60.4%) completed 6-month measures. Among completers, the clinic arm improved on 4 measures and community arm on 3 (all P<0.05). Effect sizes were small to moderate (0.41 to 0.52). In ITT analyses, both arms improved on 4 of 5 measures (all Pā¤0.001) versus baseline with clinically significant changes in BPI pain severity and interference. Improvement in multiple outcomes after this chronic pain self-management program for low income patients warrants further study.
This intervention was registered with Clinicaltrials.gov and can be found using identifier NCT02906358.
In an evaluation of a low literacy, 6-month chronic pain self-management program, similar improvements were observed among primarily Hispanic participants whether the intervention was delivered by a health educator or in groups with lectures from experts.