INDIANAPOLIS – A successful pilot study to address health inequities related to chronic pain and depression has received notification of further National Institutes of Health funding to begin a full-scale clinical trial.
Black patients often suffer greater pain severity, experience worse pain outcomes and are offered fewer treatment choices than White patients. Depressive symptoms compound the issue by interfering with a patient’s ability to engage in and maintain pain self-management activities.
The study, “Equity Using Interventions for Pain and Depression (EQUIPD),” is an intervention that seeks to address pain treatment disparities by partnering with and empowering Black patients with chronic pain and depression to find safe, effective approaches to chronic pain that best match their values, preferences and lifestyles. Marianne Matthias, PhD, who is an Indiana University School of Medicine senior research professor of medicine, Regenstrief Institute research scientist and Veterans Health Administration core investigator, who conducted the pilot study, will lead the second phase of the trial. Funding is expected to be more than $2.1 million over three years.
“We know from prior research that Black patients with pain are not only offered fewer treatment options than White patients, but that Black patients also tend to have fewer positive experiences communicating with healthcare providers,” said Dr. Matthias. “Our goal in this study is to make explicit different non-medication options patients have, while at the same time helping to provide them with tools to advocate for themselves and share their preferences and opinions about pain treatment with their doctors.”
The EQUIPD intervention uses individual coaching to help patients work through different non-medication treatment options, making explicit what is involved in different options and helping patients find an option that aligns best with their values and lifestyles. Personalized guidance educates patients on available options and supports them in setting and achieving pain management goals.
“By equipping patients with knowledge and tools to effectively communicate what is most important to them about managing their pain, patients are in a stronger position to work collaboratively with their doctors and find pain treatments that they are more likely to stick to, and, as a result, more likely to benefit from,” said Dr. Matthias.
In this second phase of the trial, the research team will conduct a fully powered randomized clinical trial and evaluate facilitators and barriers to system-wide implementation. The project is funded by the National Institutes of Health HEAL Initiative, grant 4R33NR020845-02.
Other researchers on the project include Nicole Fowler, PhD, Regenstrief and IU School of Medicine; Adam Hirsh, PhD, and Kevin Rand, PhD, IU Indianapolis School of Science; and Joanne Daggy, PhD, IU School of Medicine.
Marianne S. Matthias, PhD
In addition to her role as a research scientist at Regenstrief Institute, Marianne S. Matthias, PhD, is a core investigator for the U.S. Department of Veterans Affairs Health Systems Research Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis. She is also a senior research professor of medicine at Indiana University School of Medicine.
