Table 3.
Outcomes at baseline and 12 months and between-group differences at 12 months
| Outcome measure modeled as: | Inter-ventiona | Usual careb | Between-group differences for intervention vs usual care at 12 months | |||
|---|---|---|---|---|---|---|
| Observed | Estimatedc | |||||
| Continuous outcomes | Mean (SD) | Mean (SD) | Differences in Means (95% CI) | P d | Differences in Means (95% CI) | P |
| PAM-13 score | ||||||
| Baseline | 65.8 (15.0) | 65.2 (15.9) | ||||
| 12 months | 67.7 (14.8) | 66.6 (14.0) | 1.07 (-2.01 to 4.14) | .49 | -0.10 (-2.97 to 2.78) | .95 |
| PROMIS—Quality of Lifee | ||||||
| Global Physical Health | ||||||
| Baseline | 38.3 (6.3) | 38.2 (6.1) | ||||
| 12 months | 40.9 (7.6) | 39.0 (6.3) | 1.97 (0.49 to 3.45) | .01 | 1.63 (0.27 to 2.98) | .02 |
| Global Mental Health | ||||||
| Baseline | 45.8 (9.4) | 45.1 (8.3) | ||||
| 12 months | 47.8 (8.0) | 46.9 (8.3) | 1.61 (-0.08 to 3.30) | .06 | 1.33 (-0.37 to 3.03) | .12 |
| Pain intensity (scale 1–10) | ||||||
| Baseline | 6.7 (1.4) | 6.7 (1.6) | ||||
| 12 months | 5.8 (2.1) | 6.1 (1.7) | -0.28 (-0.69 to 0.12) | .22 | -0.28 (-0.63 to 0.07) | .12 |
| Prescription opioid use, MME/day | ||||||
| Baseline | 35.8 (68.9) | 32.1 (43.8) | ||||
| 12 months | 28.0 (70.7) | 25.3 (32.9) | 2.73 (-8.79 to 14.23) | .64 | 4.08 (-6.97 to 15.13) | .47 |
| Binary outcomes | N (%) | N (%) | Differences in Proportion (95% CI) | P f | Odds Ratio (95% CI) | P |
| Moderate to severe depressiong | ||||||
| Baseline | 49 (25.9) | 46 (24.7) | ||||
| 12 months | 25 (15.1) | 45 (25.6) | -0.11 (-0.19 to -0.02) | .02 | 0.40 (0.18 to 0.87) | .02 |
| Use of Patient Portal | ||||||
| Used health and wellness resources | ||||||
| Baseline | 47 (25.0) | 42 (22.6) | ||||
| 12 months | 76 (45.8) | 50 (28.4) | 0.17 (0.07 to 0.27) | < .001 | 2.50 (1.42 to 4.40) | .002 |
| Checked labs or immunization historyh | ||||||
| Baseline | 160 (85.1) | 157 (84.4) | ||||
| 12 months | 133 (80.1) | 118 (67.0) | 0.13 (0.04 to 0.22) | .006 | 2.70 (1.29 to 5.65)i | .008i |
| Pain Management Strategies | ||||||
| Meditation, relaxation, or mindfulness | ||||||
| Baseline | 64 (33.9) | 50 (26.7) | ||||
| 12 months | 61 (36.7) | 34 (19.3) | 0.17 (0.08 to 0.27) | < .001 | 2.72 (1.61 to 4.58) | < .001 |
| Exercise, stretching or physical therapy | ||||||
| Baseline | 108 (57.1) | 95 (50.8) | ||||
| 12 months | 127 (76.5) | 100 (56.8) | 0.20 (0.10 to 0.29) | < .001 | 2.24 (1.29 to 3.88) | .004 |
| Ordinal outcomes (scale 1–5) | Mean (SD) | Mean (SD) | Differences in Means (95% CI) | P d | Odds Ratio (95% CI) | P |
| Overall health | ||||||
| Baseline | 2.7 (0.9) | 2.6 (0.9) | ||||
| 12 months | 2.7 (0.9) | 2.4 (0.9) | 0.29 (0.09 to 0.49) | .004 | 3.14 (1.64 to 6.01) | < .001 |
| Function | ||||||
| Social activity and roles | ||||||
| Baseline | 3.3 (1.1) | 3.1 (1.1) | ||||
| 12 months | 3.3 (1.0) | 3.1 (0.9) | 0.24 (0.04 to 0.44) | .02 | 1.51 (0.91 to 2.51) | .11 |
| Everyday physical activities | ||||||
| Baseline | 3.4 (1.0) | 3.3 (1.0) | ||||
| 12 months | 3.6 (1.1) | 3.3 (1.1) | 0.28 (0.04 to 0.51) | .02 | 1.54 (0.89 to 2.68) | .13 |
Abbreviations: SD standard deviation. CI confidence interval. PAM-13 Patient Activation Measure-13, PROMIS Patient-Reported Outcomes Measurement Information System, MME morphine milligram equivalents
aN = 189 at Baseline; N = 166 at 12 months
bN = 187 at Baseline; N = 176 at 12 months
cModeled with generalized estimating equation (GEE); Outcomes were modeled separately; The independent variables in the models of study outcomes were time, intervention, the interaction of time intervention, baseline Chronic Pain Coping Inventory-42 (CPCI-42) relaxation, and baseline CPCI-42 exercise (CPCI relaxation and exercise were statistically different in the study arms at baseline)
dT-test
ePROMIS Global Health raw scores are converted to T-scores, with a mean of 50 and a standard deviation of 10
fChi-square
gModerate to severe depression as measured by a Patient Health Questionnaire-9 score ≥ 10
hFor this self-reported measure at baseline, patients were asked if they ever used the service. At the 12-month follow-up survey, patients were asked about their use in the previous 6 months. Since the ‘ever used’ proportion was higher than the 12-month proportion, baseline values were excluded from the model and only the 6th and 12th month values were used