Optimizing Patient Engagement in a Novel Pain Management Initiative (OPEN)
Condition: Chronic Pain
MeSH terms: Chronic Pain
Study type: Interventional

Summary: 
      The OPEN study has two aims: The first is to identify what helps to keep patients involved
      with a Medicaid chronic pain management program and to identify features of an ideal
      text-message-based program for people enrolled in the program. The second aim is to develop
      the text-message-based program (OPENtext), then find out how useful this intervention is
      compared to a patient navigator intervention (OPENnav) for increasing patient engagement,
      improving patient's motivation to manage their chronic pain, and improving patient confidence
      in self-managing their chronic pain condition.
    

Detailed description: 
      Chronic pain is a condition that affects the most fundamental aspects of quality of life.
      Treatment for chronic pain is challenging and usually takes the form of opioid medication
      therapy. But chronic opioid therapy is also associated with high rates of emergency
      department use, drug diversion, addiction, and unintentional overdose deaths. The new RI
      Medicaid Chronic Pain Initiative (CPI) targets patients who are both high emergency
      department users and experiencing chronic pain. In the CPI, patients can be prescribed an
      integrated treatment plan of massage, chiropractic, or acupuncture therapies. This is a novel
      approach to chronic pain care, but retention and patient engagement are low. It is important
      to understand why involvement in the CPI is low, how to improve the patient experience, and
      how to support the prescribed CAM therapies.

      This study has two aims: The first is to identify what helps to keep patients involved with
      the CPI program and to identify features of an ideal text-message-based program for people
      enrolled in the CPI. The second aim is to develop the text-message-based program (OPENtext),
      then find out how useful this intervention is compared to a patient navigator intervention
      (OPENnav) for increasing patient engagement, improving patient's motivation to manage their
      chronic pain, and improving patient confidence in self-managing their chronic pain condition.

      Investigators will conduct qualitative interviews with patients, providers, and
      administrators. Goals of the interviews will be: to understand the patient experience in the
      CPI, including experiences with the navigation approach currently in place; to identify
      barriers and facilitators to CPI participation; and to learn how technology-especially cell
      phone text-messaging-could help support pain care and CPI engagement. These interviews will
      help develop a text-message-based intervention and provide feedback to existing patient
      navigator programming. Next, investigators will develop and test the text-message patient
      support intervention that will contain patient-identified topics and concerns that emerge
      from the qualitative interviews and topic areas discussed by a stakeholder Advisory Board.
      Theories of behavior change will be used to help with message development, and patients will
      take part in helping to test and fine-tune the intervention. Last, investigators will compare
      the text-message and patient navigation interventions in a randomized controlled study with
      200 patients over a six-month period. Investigators will see which approach helps patients
      increase their involvement in the CPI and better manage their chronic pain. If successful,
      chronic pain patients across Medicaid programs could benefit from use of the patient
      navigation or the text-message intervention.
    

Intervention name(s): OPENtext; OPENnav
Intervention type(s): Other; Other
Intervention description(s): Participants will receive 12 weeks of daily text messages sent from an automated system. The text messages will assist participants in managing their chronic pain.; Particpants will be linked with a RIPN PEER Navigator who will assisted them in managing their health care
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Chronic pain; Complementary and alternative therapies; Mobile health; Medicaid; Patient navigation