Trial Summary

Chronic pain is a growing concern for society, contributing substantially to the ongoing opioid epidemic. Back pain is the most common chronic pain diagnosis and is the most common reason for prescribing opioids. Clinical practice guidelines and opioid-prescribing recommendations make it clear that nonpharmacologic pain treatments are preferable to opioids for patients with back pain, yet over-prescribing of opioids to individuals with back pain persists. Primary care providers serving rural and low income communities face specific challenges to providing nonpharmacologic pain care. Nonpharmacologic care providers are often absent from these communities, and even if present may be inaccessible to patients with limited resources. Many rural and low-income communities are served by federally qualified health centers (FQHCs). FQHCs often serve communities at the forefront of the opioid crisis but too often lack options to provide accessible nonpharmacologic alternatives to the patients they serve.

BeatPain Utah is an embedded pragmatic clinical trial that will compare the effectiveness of nonpharmacologic intervention strategies for patients with back pain seeking care in FQHCs throughout the state of Utah. The strategies evaluated are designed to overcome the barriers specific to rural and low-income communities served by FQHC clinics through the innovative use of e-referral and telehealth resources. The BeatPain Utah interventions include:

• A telehealth strategy that provides a brief pain teleconsult along with phone-based physical therapy.
• An adaptive strategy that provides the brief pain teleconsult first, followed by phone-based physical therapy among patients who are nonresponsive to treatment.

The study will also evaluate implementation outcomes to inform future efforts to scale effective strategies into other low-resource health care settings.

NIH Project Information