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J Gen Intern Med. 2018 May;33(Suppl 1):11-15. doi: 10.1007/s11606-018-4345-6.

A Research Agenda for Advancing Non-pharmacological Management of Chronic Musculoskeletal Pain: Findings from a VHA State-of-the-art Conference.

Author information

1
Pain Research, Informatics, Multimorbidities & Education Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, 06516, USA. william.becker@yale.edu.
2
Yale School of Medicine, New Haven, CT, USA. william.becker@yale.edu.
3
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
4
Pain Research, Informatics, Multimorbidities & Education Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
5
Yale School of Medicine, New Haven, CT, USA.
6
VA Boston Healthcare System, Boston, MA, USA.
7
Boston University School of Medicine, Boston, MA, USA.
8
Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
9
Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI, USA.
10
VA North Texas Health Care System, Dallas, TX, USA.
11
Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
12
Center for Health Services Research in Primary Care, Durham VA Healthcare System, Durham, NC, USA.
13
Department of Medicine & Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.

Abstract

Chronic pain is widely prevalent among Veterans and can have serious negative consequences for functional status and quality of life among other domains. The Veterans Health Administration (VHA) convened a state-of-the-art (SOTA) conference to develop research priorities for advancing the science and clinical practice of non-pharmacological management of chronic musculoskeletal pain. In this perspective article, we present the methods and consensus recommendations for research priorities emanating from the SOTA. In the months leading up to the SOTA, a core group of researchers defined four areas of focus: psychological/behavioral therapies; exercise/movement therapies; manual therapies; and models for delivering multi-modal pain care and divided into workgroups. Each workgroup, in their respective areas of focus, identified seminal studies capturing the state of the evidence. Herein, we present consensus recommendations ranging from efficacy to effectiveness to implementation/dissemination research depending on the state of the evidence as assessed by participants, including commentary on common elements across workgroups and future areas of innovation in study design, measurement, and outcome ascertainment.

KEYWORDS:

chronic pain management; clinical research; non-pharmacologic treatments

PMID:
29633136
PMCID:
PMC5902349
[Available on 2019-05-01]
DOI:
10.1007/s11606-018-4345-6

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