Evidence mapPaperPMID 37269070Full record

Trial reportClinical trials (London, England)2023

Partner engagement for planning and development of non-pharmacological care pathways in the AIM-Back trial.

Lindsay A Ballengee, Heather A King, Corey Simon, Trevor A Lentz, Kelli D Allen, Catherine Stanwyck, Micaela Gladney, Steven Z George, S Nicole Hastings

Registry-linked trialOpen access · greenAbstract readPragmatic Clinical Trial
In one paragraph

Trial report in Clinical trials (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04411420 (Improving Veteran Access to Integrated Management of Back Pain), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04411420 nacompletednot on this map

Improving Veteran Access to Integrated Management of Back Pain: A Pragmatic, Cluster Randomized Trial

TypeinterventionalSponsorDuke UniversityRan2021 to 2025Enrolled1,817ConditionsLow Back Pain, Veterans FamilyArmsPain modulation with physical pain treatment, Telephone delivered self-management counseling for increasing physical activity, Telephone delivered behavioral treatment for participants with high risk for continued disability, Patient preference treatment protocol, Nonpharmacological guideline adherent treatment protocol
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Lindsay A BallengeeCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.ORCID 0000-0002-6555-3867
Heather A KingCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
Corey SimonDepartment of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.
Trevor A LentzDepartment of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.
Kelli D AllenCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
Catherine StanwyckCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
Micaela GladneyCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
Steven Z GeorgeCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
S Nicole HastingsCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
Duke University · USDurham VA Health Care System · USUniversity of North Carolina at Chapel Hill · US

Funding

NIH-DOD-VA Pain Management Collaboratory Coordinating CenterU24AT009769 · YALE UNIVERSITY · 2025 to 2025
$1.4M
Research Education Component (REC)P30AG028716 · DUKE UNIVERSITY · 2025 to 2025
$1.3M
HSRD VA CIN 13-410NCCIH NIH HHS U24 AT009769NCCIH NIH HHS UG3 AT009790NCCIH NIH HHS UH3 AT009790NIA NIH HHS P30 AG028716
6 · The paper itself

Abstract

BACKGROUND/

aimsEmbedded pragmatic clinical trials are increasingly recommended for non-pharmacological pain care research due to their focus on examining intervention effectiveness within real-world settings. Engagement with patients, health care providers, and other partners is essential, yet there is limited guidance for how to use engagement to meaningfully inform the design of interventions to be tested in pain-related pragmatic clinical trials. This manuscript aims to describe the process and impacts of partner input on the design of two interventions (care pathways) for low back pain currently being tested in an embedded pragmatic trial in the Veterans Affairs health care system.

methodsSequential cohort design for intervention development was followed. Engagement activities were conducted with 25 participants between November 2017 and June 2018. Participants included representatives from multiple groups: clinicians, administrative leadership, patients, and caregivers.

resultsPartner feedback led to several changes in each of the care pathways to improve patient experience and usability. Major changes to the sequenced care pathway included transitioning from telephone-based delivery to a flexible telehealth model, increased specificity about pain modulation activities, and reduction of physical therapy visits. Major changes to the pain navigator pathway included transitioning from a traditional stepped care model to one that offers care in a feedback loop, increased flexibility regarding pain navigator provider type, and increased specificity for patient discharge criteria. Centering patient experience emerged as a key consideration from all partner groups.

conclusionDiverse input is important to consider before implementing new interventions in embedded pragmatic trials. Partner engagement can increase acceptability of new care pathways to patients and providers and enhance uptake of effective interventions by health systems.

trial registrationNCT#04411420. Registered on 2 June 2020.

Indexed as

Critical PathwaysPainHumanscare pathwaysnon-pharmacologicalpain navigatorPartner engagementpragmatic clinical trial

Identifiers

PMID37269070
PMCPMC10524642
OpenAlexW4379197705

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.