Background
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www.researchgate.net/project/OPEN-Comparative- Effectiveness-Randomized-Control-Trial-RCT
RESEARCHGATE REPORT
Chronic pain is a debilitating condition that affects the most fundamental aspects of patient quality of life. Yet effective chronic pain management is clinically challenging. As part of an innovative solution, the Rhode Island Medicaid program introduced the Communities of Care initiative in November 2010 and a focused chronic pain initiative (CPI) in June 2012. The CPI targets 1500 members who are high emergency department utilizers suffering from chronic pain and offers: case management team, patient self-help, behavioral healthcare, and traditional and complementary therapies (massage, chiropractic, and acupuncture). However, retention and engagement are known challenges in this setting. One way to address these challenges is through the use of mobile technology (using GoMo Health Personal Concierge: a two-way BOT with a behavioral modification engagement science; called OPENtext for this research program), which has been at the forefront of patient self-management across a number of health problems. Patient navigation interventions also show promise for engaging marginalized populations in care.
OBJECTIVES
1. To better understand the challenges of engaging in the CPI program.
2. To develop and test a 12-week text-message intervention (OPENtext) compared with a patient navigation approach (OPENnav) to increase patient engagement and self-management of chronic pain.
METHODS
An advisory board guided the study, conducting 48 qualitative interviews with patients, providers, and health system administrators to understand facilitators and barriers to CPI engagement and define content, delivery, and functional specifications of an optimal text-message intervention for enrollees. Based on these findings, incorporating elements of existing evidence-based chronic pain self-management content, and employing behavior change theories, we developed and pilot tested a text message intervention for CPI enrollees. Finally, in a randomized controlled trial with 197 CPI patients, we compared the effectiveness of OPENtext to OPENnav
BACKGROUND | ACHIEVING THE TRIPLE AIM WITH CHRONIC PAIN MEDICAID PATIENTS
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