Treating Persistent Pain: A Nurse Co-Led, Interdisciplinary Model for Primary Care.
Lindsay L Benes, Frank J Keefe, Lynn L DeBar
PMID 35922272WHAT IT FOUND
Nurse co-led interdisciplinary pain self-management program in primary care was associated with lower pain severity, disability, and interference with enjoyment of life, general activity, and sleep than usual care; opioid use did not differ.
Key findings
01PPACT was delivered to 851 adults with persistent pain on long-term opioid therapy over 16-18 weeks by nurse or behavioral specialist-led teams that included physical therapists, pharmacists, and primary care providers.
02Compared with usual care, PPACT patients had greater reductions in pain severity, pain-related disability, and pain-related interference with enjoyment of life, general activity, and sleep over one full year, and greater satisfaction with pain-related care and primary care services.
03Opioid use did not differ significantly between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
This is a program and training description, not a full trial report. Randomisation, blinding, allocation concealment, dropout numbers, pre-specified primary outcomes, effect sizes, and p-values are not reported. PPACT combined many components, including nurse or behavioral specialist coaching, group sessions, individual calls, physical therapy, pharmacist medication review, and primary care provider collaboration, so the article cannot show which component produced the outcomes. The program targeted adults on long-term opioid therapy within Kaiser Permanente and excluded cancer-related pain, hospice or palliative care, current addiction services or active substance dependence, and severe cognitive impairment, so it may not apply to all persistent pain patients. Nurse perceptions are mentioned but not reported with interview data or analysis.
Declared interests
The authors declared no known competing financial interests or personal relationships that could have appeared to influence the work. The publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that nurses alone improved pain outcomes. PPACT combined nurse or behavioral specialist coaching, group sessions, individual calls, physical therapy, pharmacist medication review, and primary care provider collaboration, and the article does not separate the contribution of any component.