PRIMARY CARE & HEALTH SERVICES SECTION Brief Research Report A Brief Peer Support Intervention for Veterans with Chronic Musculoskeletal Pain: A Pilot Study of Feasibility and Effectiveness

Department of Medicine, School ofMedicine, Indiana University, IndianapolisIndiana, USAReprint requests to: Marianne S. Matthias, PhD, VAHSRD Fax: 317-988-3222; E-mail: mmatthia@iupui.edu.Disclosure: The authors declare no conflicts of inter-est.AbstractObjective. The aim of this study was to pilot test apeer support intervention, involving peer delivery ofpain self-management strategies, for veterans withchronic musculoskeletal pain.Design. Pretest/posttest with 4-month interventionperiod.Methods. Ten peer coaches were each assigned 2patients (N520 patients). All had chronic musculo-skeletal pain. Guided by a study manual, peercoach–patient pairs were instructed to talk biweeklyfor 4 months. Pain was the primary outcome andwas assessed with the PEG, a three-item version ofthe Brief Pain Inventory, and the PROMIS Pain Inter-ference Questionnaire. Several secondary out-comes were also assessed. To assess change inoutcomes, a linear mixed model with a randomeffect for peer coaches was applied.Results. Nine peer coaches and 17 patients com-pleted the study. All were male veterans. Patients’pain improved at 4 months compared with baselinebut did not reach statistical significance (PEG:P50.33, ICC [intra-class correlation]50.28,Cohen’s d520.25; PROMIS: P50.17, d520.35).Of secondary outcomes, self-efficacy (P50.16,ICC50.56, d50.60) and pain centrality (P50.06,ICC50.32, d520.62) showed greatest improve-ment, with moderate effect sizes.Conclusions. This study suggests that peers caneffectively deliver pain self-management strategiesto other veterans with pain. Although this was apilot study with a relatively short interventionperiod, patients improved on several outcomes.Key Words. Chronic Pain; Pain Management;Social SupportIntroductionPain is prevalent and costly, affecting at least 100 millionAmericans and amounting to up to $635 billion annuallyin direct medical costs and lost worker productivity [1].Chronic pain affects 40–70% of veterans and is a lead-ing cause of disability, resulting in substantial negativeimpact on millions of veterans’ lives [2,3].Pain self-management involves treatment adherence,behavioral change, and coping skills, and is an