UH3 Project: Collaborative Care for Chronic Pain in Primary Care (PPACT)

UH3 Project: Collaborative Care for Chronic Pain in Primary Care (PPACT)


Principal Investigator: Lynn DeBar, PhD

Sponsoring Institution: Kaiser Permanente Center for Health Research

Collaborators:

  • Kaiser Permanente regional health systems in Georgia, Northwest, and Hawaii
  • Oregon Health and Science University

NIH Institutes Providing Oversight:

Program Official: Linda Porter (NINDS)

Project Scientist: Sarah Duffy (NIDA)

ClinicalTrials.gov Identifier: NCT02113592

Study Locations: Primary care clinics in 3 regional health systems 

Trial Status: Completed

Common chronic pain conditions are expensive and pervasive, affect at least 116 million American adults at an annual cost of $560 billion in direct medical treatment costs and lost productivity, and disproportionately affect vulnerable populations. Pain is the primary reason patients seek medical care, and as the first point of contact, primary care providers (PCPs) deliver the majority of that care. But PCPs face many challenges in managing patients’ care and often have little specific training in pain medicine. Yet with proper system support, PCPs are in the best position to coordinate long-term pain management.

PPACT is a large mixed-methods, pragmatic, cluster-randomized clinical trial conducted in 3 regions of Kaiser Permanente health systems: Northwest, Georgia, and Hawaii. The PPACT trial is evaluating integration of multidisciplinary services within the primary care environment compared with usual care in these settings. The trial combines a number of treatment approaches, including physical therapy and psychological interventions. Patients will be supported in taking a more active role in managing their pain, and primary care providers will receive additional support and guidance in treating patients with chronic pain.

NIH Project Information

Presentation

5/1/2019: Presentation to NIH Collaboratory Steering Committee (slides)

Interviews

4/20/2015: Interview on lessons learned with principal investigator Dr. Lynn DeBar (PDF)

4/14/2014: Interview on planning challenges with principal investigator Dr. Lynn DeBar (video)

10/23/2012: Interview with principal investigator Dr. Lynn DeBar (video)

Supplementary Material

Regulatory and Ethics Support Documentation

Tools

PPACT Patient Recruitment Letter

Publications

Taking opioids in times of crisis: institutional oversight, chronic pain and suffering in an integrated healthcare delivery system in the U.S. Int J Drug Policy. 2019;74:62-68.

Development and assessment of a crosswalk between ICD-9-CM and ICD-10-CM to identify patients with common pain conditions. J Pain. 2019;20(12):1429-1445.

Satisfaction with primary care providers and health care services among patients with chronic pain: a mixed-methods study. J Gen Intern Med. 2019 Oct 21. doi: 10.1007/s11606- 019-05339-2. [Epub ahead of print]

Interdisciplinary team-based care for patients with chronic pain on long-term opioid treatment in primary care (PPACT) - protocol for a pragmatic cluster randomized trial. Contemp Clin Trials. 2018;67:91-99.

Automating collection of pain-related patient-reported outcomes to enhance clinical care and research. J Gen Intern Med. 2018;33(Suppl 1):31-37.

A primary care-based interdisciplinary team approach to the treatment of chronic pain utilizing a pragmatic clinical trials framework. Transl Behav Med. 2012;2(4):523-530.

Presentations

5/1/2019: Presentation to NIH Collaboratory Steering Committee (slides)

5/14/2018: Presentation to NIH Collaboratory Steering Committee (slides)

5/23/2017: Presentation on Top Barriers/Challenges and Recent Generalizable Lessons Learned to NIH Collaboratory Steering Committee (slides)

10/14/2016: PCT Grand Rounds: "Multidisciplinary Chronic Pain Management in Primary Care: Paradox or Paradigm?" (video; slides)

5/9/2016: Presentation on Data Governance and Data Sharing to NIH Collaboratory Steering Committee (slides)

5/9/2016: Presentation on Generalizable Lessons Learned to NIH Collaboratory Steering Committee (slides)

4/21/2015: Presentation to NIH Collaboratory Steering Committee (slides)

11/21/2014: PCT Grand Rounds: "Successes Evolving from Constraints: Lessons Learned about Embedding Complex Pragmatic Trials in Delivery Systems" (video; slides)

8/20/2014: Presentation on Lessons Learned to NIH Collaboratory Steering Committee (slides)

2/24/2014: Presentation on Data Sharing to NIH Collaboratory Steering Committee (slides)

1/18/2013: PCT Grand Rounds: "Systematizing Our Approach for Ensuring PRO Data Quality and Stakeholder Engagement" (video; slides)

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Citation:

Demonstration Projects: UH3 Project: Collaborative Care for Chronic Pain in Primary Care (PPACT). In: Rethinking Clinical Trials: A Living Textbook of Pragmatic Clinical Trials. Bethesda, MD: NIH Health Care Systems Research Collaboratory. Available at: https://rethinkingclinicaltrials.org/demonstration-projects/uh3-project-collaborative-care-for-chronic-pain-in-primary-care-ppact/. Updated January 13, 2020.