A Brief Peer Support Intervention for Veterans with Chronic Musculoskeletal Pain: A Pilot Study of Feasibility and Effectiveness

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Abstract

Objective.

The aim of this study was to pilot test a peer support intervention, involving peer delivery of pain self-management strategies, for veterans with chronic musculoskeletal pain.

Design.

Pretest/posttest with 4-month intervention period.

Methods.

Ten peer coaches were each assigned 2 patients (N = 20 patients). All had chronic musculoskeletal pain. Guided by a study manual, peer coach–patient pairs were instructed to talk biweekly for 4 months. Pain was the primary outcome and was assessed with the PEG, a three-item version of the Brief Pain Inventory, and the PROMIS Pain Interference Questionnaire. Several secondary outcomes were also assessed. To assess change in outcomes, a linear mixed model with a random effect for peer coaches was applied.

Results.

Nine peer coaches and 17 patients completed the study. All were male veterans. Patients' pain improved at 4 months compared with baseline but did not reach statistical significance (PEG:P= 0.33, ICC [intra-class correlation] = 0.28, Cohen'sd= −0.25; PROMIS:P= 0.17,d= −0.35). Of secondary outcomes, self-efficacy (P= 0.16, ICC = 0.56,d= 0.60) and pain centrality (P= 0.06, ICC = 0.32,d= −0.62) showed greatest improvement, with moderate effect sizes.

Conclusions.

This study suggests that peers can effectively deliver pain self-management strategies to other veterans with pain. Although this was a pilot study with a relatively short intervention period, patients improved on several outcomes.

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