COMPASS-NP for Pain Management

(COMPASS-NP Trial)

Overseen By Ryan Olson, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon Health and Science University

Disqualifiers: Prior COMPASS, Recent surgery, Pregnancy

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

140 Participants Needed

Trial Summary

What is the purpose of this trial?

Home care workers (HCWs) are at-risk for chronic pain and associated problems, including emotional distress, opioid use and misuse, and work-related disability. To address these issues, the proposed study will adapt an established peer-led and supportive group program to address the needs of HCWs with chronic pain. The new program, named COMPASS for Navigating Pain (COMPASS-NP), will integrate work-based injury protections with pain education and cognitive-behavioral therapy strategies for pain self-management in order to reduce pain interference with HCWs' work and life, and advance their safety, health, and well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the COMPASS-NP treatment for pain management?

Research shows that educational interventions and collaborative approaches in pain management can lead to significant reductions in pain and improved patient satisfaction. For example, trained providers using a structured approach had patients with less pain, and collaborative models improved pain management outcomes. ^{1 2 3 4 5}

How is the COMPASS-NP treatment for pain management different from other treatments?

The COMPASS-NP treatment is unique because it involves a community of practice and safety support, focusing on nurse practitioners and interdisciplinary teams to manage pain, rather than relying solely on medications like opioids. This approach emphasizes collaboration, education, and the use of best practices to improve patient outcomes and satisfaction. ^{6 7 8 9 10}

Eligibility Criteria

This trial is for adult home care workers who have chronic pain (lasting over 3 months and with an intensity above 4), which interferes with their work. Participants must be currently working at least 4 hours a week and have internet access plus a video-capable device.

Inclusion Criteria

I work at least 4 hours a week.

Access to the internet with a video capable device (e.g., smart phone, tablet, or computer)

Employed as a home care worker

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the COMPASS-NP intervention, which includes 10 weekly group sessions focusing on pain education and cognitive-behavioral therapy strategies for pain self-management.

10 weeks

10 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention, with no treatment provided during this period.

10 weeks

Waitlist Control

Participants in the waitlist control group receive usual practice during the first 10 weeks, followed by the COMPASS-NP intervention in the subsequent 10 weeks.

20 weeks

Treatment Details

Interventions

• COMmunity of Practice And Safety Support for Navigating Pain (COMPASS-NP)

Trial Overview The COMPASS-NP program is being tested to see if it can help home care workers manage chronic pain better, reduce its impact on their work and life, and improve overall safety, health, and well-being through peer support groups integrating injury prevention, education, and cognitive-behavioral therapy strategies.

Participant Groups

Group I: Waitlist Control Experimental Treatment 1 Intervention

Usual practice during weeks 0-10. Intervention during weeks 11-20 (10 weekly group sessions).

Group II: Intervention Experimental Treatment 1 Intervention

Intervention during weeks 0-10 (10 weekly group sessions). Follow-up with no treatment during weeks 11-20.

Who Is Running the Clinical Trial?

Oregon Health and Science University

Lead Sponsor

Trials

1,024

Recruited

7,420,000+

Findings from Research

An educational intervention for cancer pain management significantly improved patient outcomes, with trained providers showing a notable reduction in patient pain levels over 4 months compared to untrained providers.

While the training led to better prescribing practices for co-analgesics, the effectiveness of the intervention diminished over time, highlighting the need for ongoing education to maintain improved pain management outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An educational implementation of a cancer pain algorithm for ambulatory care. Du Pen, AR., Du Pen, S., Hansberry, J., et al.[2013]

The Chronic Pain Network (CPN) successfully integrated patient partners into its research framework, leading to significant impacts such as building community, enhancing knowledge and skills, and influencing research priorities across various levels of the network.

The evaluation highlighted that patient engagement not only improved individual experiences and coping with chronic pain but also fostered a culture change within the research community, demonstrating the value of including patient perspectives in health research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the impacts of patient engagement on a national health research network: results of a case study of the Chronic Pain Network. Tripp, L., Richards, DP., Daly-Cyr, J., et al.[2023]

A multidisciplinary approach involving collaboration between academic scientists and various healthcare professionals led to the development of 14 effective pain management clinical pathways, which significantly reduced patients' pain during their hospital stay.

Patients using these pathways reported improved quality of life and greater satisfaction with their caregivers, although these benefits diminished after discharge, highlighting the need for continued pain management strategies post-hospitalization.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using a collaborative research utilization model to develop and test the effects of clinical pathways for pain management. Dufault, MA., Willey-Lessne, C.[2019]

An interdisciplinary model for pain management was developed within an integrated health care system, focusing on improving outcomes across various care settings, including acute care and home care.

The model established four key clinical indicators to measure pain management effectiveness, emphasizing strategies like staff accountability and patient education to enhance overall care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Road to excellence in pain management: research, outcomes and direction (ROAD). Vega-Stromberg, T., Holmes, SB., Gorski, LA., et al.[2019]

Patients after orthopedic surgery received less than 50% of the available narcotic doses for pain relief during the first 24 hours post-surgery, indicating potential under-treatment of pain.

Nurses documented less than 25% of the ideal occurrences for pain assessment, suggesting that inadequate documentation may hinder effective pain management and patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pain management documenting the decision making process. Malek, CJ., Olivieri, RJ.[2004]

Pain nurses and nurse practitioners in Australia play a crucial role in managing both acute (92.7%) and chronic pain (80.5%), and they are actively involved in educating patients and clinicians, as well as developing policies.

A significant majority (97.6%) of pain nurses believe there is an over-prescription of opioids in Australia, and nurse practitioners are positioned to help mitigate opioid use by adjusting medication doses, highlighting their potential in improving opioid management strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Pain Nurse Practitioner and Pain Nurse's Role and Views on Opioid Management in Australia: A National Questionnaire Survey. Sonneborn, O., Miller, C.[2022]

The implementation of a Nurse Practitioner (NP) role in Acute Pain Management has significantly improved patient access to timely pain relief, particularly for those undergoing major surgery or caesarean sections, by utilizing a range of non-pharmacological and pharmacological interventions.

Data collected over 200 working days indicate that the NP has effectively provided safe and contemporary pain management, aligning with successful NP role developments seen in various healthcare settings both in Australia and internationally.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Two hundred days of nurse practitioner prescribing and role development: a case study report from a hospital-based acute pain management team. Schoenwald, AV.[2011]

A program that integrated nurses and behavioral specialists into an interdisciplinary team significantly improved care for patients with chronic pain on long-term opioid treatment, leading to greater reductions in pain severity and related disabilities compared to usual care.

Patients involved in this program reported higher satisfaction with their pain management and primary care services, highlighting the effectiveness of the National Pain Strategy (NPS) recommendations in practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treating Persistent Pain: A Nurse Co-Led, Interdisciplinary Model for Primary Care. Benes, LL., Keefe, FJ., DeBar, LL.[2023]

A survey of 16 nurse practitioners in Ontario revealed that while most use pain-assessment tools, less than half follow clinical practice guidelines for pain management, indicating a gap in adherence to best practices.

Despite recognizing their potential role, NPs reported being underutilized in prescribing pain medications and leading pain management efforts, facing barriers such as time constraints and collaboration issues with physicians.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Optimizing the role of the nurse practitioner to improve pain management in long-term care. Kaasalainen, S., DiCenso, A., Donald, FC., et al.[2009]

The audit and feedback (A/F) intervention significantly improved nurse practitioners' adherence to cancer pain clinical practice guidelines, leading to better patient outcomes.

Patients in the intervention group reported less pain interference in daily activities and improved satisfaction with pain relief, increasing from 68.4% to 95.1%, despite no significant change in overall pain intensity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementation of cancer pain guidelines by acute care nurse practitioners using an audit and feedback strategy. Dulko, D., Hertz, E., Julien, J., et al.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

An educational implementation of a cancer pain algorithm for ambulatory care. [2013]

2. England pubmed.ncbi.nlm.nih.gov

Evaluating the impacts of patient engagement on a national health research network: results of a case study of the Chronic Pain Network. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Using a collaborative research utilization model to develop and test the effects of clinical pathways for pain management. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Road to excellence in pain management: research, outcomes and direction (ROAD). [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Pain management documenting the decision making process. [2004]

6. United States pubmed.ncbi.nlm.nih.gov

The Pain Nurse Practitioner and Pain Nurse's Role and Views on Opioid Management in Australia: A National Questionnaire Survey. [2022]

7. Australia pubmed.ncbi.nlm.nih.gov

Two hundred days of nurse practitioner prescribing and role development: a case study report from a hospital-based acute pain management team. [2011]

8. United States pubmed.ncbi.nlm.nih.gov

Treating Persistent Pain: A Nurse Co-Led, Interdisciplinary Model for Primary Care. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Optimizing the role of the nurse practitioner to improve pain management in long-term care. [2009]

10. United States pubmed.ncbi.nlm.nih.gov

Implementation of cancer pain guidelines by acute care nurse practitioners using an audit and feedback strategy. [2021]