Comprehensive vs. Assisted Management of Mood and Pain Symptoms (CAMMPS)
Pain, Depression, Anxiety
About this trial
This is an interventional treatment trial for Pain focused on measuring Pain, Depression, Anxiety, Musculoskeletal, Fibromyalgia
Eligibility Criteria
Inclusion Criteria:
Individuals must be patients of the Richard L. Roudebush VAMC in Indianapolis, Indiana Individuals will be eligible if they have pain plus comorbid anxiety and/or depression.
Pain must:
- be musculoskeletal, either localized (in the arms, legs, back, or neck) or widespread (fibromyalgia)
- have persisted 3 months or longer despite a trial of at least one analgesic medication
- at least moderate in severity, defined as a Brief Pain Inventory average severity score of 5 or greater
- Depression must be of at least moderate severity, defined as a PHQ-8 score of 10 or greater with either depressed mood and/or anhedonia being endorsed, OR
- Anxiety must be of at least moderate severity, defined as a GAD-7 score of 10 or greater, OR
- A composite mood score (anxiety and depression) of sufficient severity, defined as a GAD-7 + PHQ-8 score of 12 or greater.
Exclusion Criteria:
Individuals will be excluded if they:
- do not speak English
- have moderately severe cognitive impairment as defined by a validated 6-item cognitive screener
- have schizophrenia, bipolar disorder or other psychosis
- have other severe mental illness and/or high risk of suicide
- are pregnant
- have an anticipated life expectancy of less than 12 months. Patients who are on antidepressants but still meet the PHQ-9 and/or GAD-7 entry criterion for clinical depression and/or anxiety may still be eligible if they have been on an adequate dose of the antidepressant for an adequate duration of time (i.e., 12 weeks).
Sites / Locations
- Richard L. Roudebush VA Medical Center, Indianapolis, IN
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Assisted Symptom Management (ASM)
Comprehensive Symptom Management (CSM)
There will be 2 principal components to assisted symptom management (ASM): automated symptom monitoring, along with pain and mood self-management modules.
This arm couples ASM with care management by a nurse-physician team, thus testing "combined" therapy vs. "monotherapy" (ASM only).