Table 2.
Characteristics of Included Studies
| Author year | N | Setting | Major intervention components | Follow-up (months) | Gender (% male) | Mean age (years) | Baseline pain intensity* | Mental health comorbidities | Study quality |
|---|---|---|---|---|---|---|---|---|---|
| Ahles 200123 | 396 | 4 PC practices (USA) | Computer-based tailored “prescription” algorithm + nurse educator | 6 | 39 | 49 | NR | 27% emotional distress | Poor |
| Ahles 200624 | 1066 | 14 PC practices (USA) | Computer-based tailored “prescription” algorithm + nurse educator | 12 | 48 | 48 | NR | 1% SUD | Fair |
| Angeles 201325 | 63 | Single center (Canada) | Group multidisciplinary education co-facilitated by an occupational therapist and a social worker | 6 | 38 | 55 | NR | 19.3% possible or probable SUD | Poor |
| Bair 20152 (ESCAPE) | 241 | 5 GM clinics (Ind. VAMC) | Stepped care with analgesics, self-management, and CBT delivered by 2 NCM | 9 | 88 | 37 | 6.6 | Mean PTSD Scorea = 26.4 Mean depression Scoreb = 11.2 |
Good |
| Burnham 201026 (CAPRI†) | 82 | Single rural center (Canada) | Weekly multidisciplinary group sessions added to analgesic optimization | 18 | 31 | 47 | 7.7 | NR | Poor |
| Dobscha 200927 (SEACAP) | 401 | 5 PC clinics (Portland VAMC) | Collaborative care delivered by psychologist care manager | 12 | 92 | 62 | 5.2 | 18% MDD, 16% PTSD | Good |
| Hay 200628 | 216 | 15 practices (England) | Pharmacist-led pharmacological treatment optimization | 12 | 36 | 62 | 6.1 | NR | Fair |
| Hill 201129 (STarT Back) | 851 | 10 practices (England) | Physiotherapist-led stratified care using STarT Back Screening Tool | 12 | 41 | 50 | 5.3 | NR | Fair |
| Kroekne 200930 (SCAMP) | 250 | 5 GM clinics (Ind. VAMC) | Stepped care with antidepressants and self-management delivered by a NCM | 12 | 47 | 56 | 6.2 | 75% MDD Mean anxiety scorec = 8.9 |
Good |
| Kroenke 201431 (SCOPE) | 250 | 5 PC clinics (Ind. VAMC) | Automated symptom monitoring and optimized analgesic management by NCM and PC pain specialist team | 12 | 83 | 55 | 5.1 | 24% MDD, 17% PTSD | Good |
Table does not include Thielke 2015, secondary publications of already included studies
Abbreviations: PC primary care, NR not reported, SUD substance use disorder, ESCAPE Evaluation of Stepped Care for Chronic Pain, GM general medicine, CBT cognitive behavioral therapy, NCM nurse case manager, PTSD post-traumatic stress disorder, CAPRI Central Alberta Pain and Rehabilitation Institute, Ind. = Indianapolis, OBS observational, SEACAP Study of the Effectiveness of a Collaborative Approach to Pain, MDD major depressive disorder, SCAMP Stepped Care for Affective Disorders and Musculoskeletal Pain, SCOPE Stepped Care to Optimize Pain Care Effectiveness, GADS Generalized Anxiety Disorder scale
*Mean score on a 10-point scale
†All studies RCT except Burnham 2010 = retrospective cohort
aDetermined using the Posttraumatic Stress Disorder Check List–17. Scores range from 0 to 68
bDetermined using Patient Health Questionnaire–9. Scores range from 0 to 27
cDetermined using the Generalized Anxiety Disorder scale. Scores range from 0 to 21