Group-Based Integrative Pain Management: Feasibility of a Factorial Randomized Trial in Safety-Net Primary Care

Area of Science:

• Integrative medicine
• Pain management
• Primary care research

Background:

• Chronic pain affects millions, necessitating accessible and effective non-pharmacologic treatments.
• Safety-net primary care clinics serve diverse, underserved populations facing barriers to multimodal pain care.
• Group-based interventions offer potential for enhanced access and social support in pain management.

Purpose of the Study:

• To assess the feasibility and acceptability of a pragmatic randomized trial for group-based non-pharmacologic pain management.
• To evaluate the impact of these interventions on pain-related outcomes in a primary care setting.
• To identify barriers and facilitators to accessing multimodal pain care within safety-net clinics.

Main Methods:

• A 2x2 factorial randomized trial involving 44 adults with chronic pain.
• Interventions included 12-week group acupuncture and integrative group medical visits (IGMVs).
• Participants were randomized to acupuncture, IGMVs, both, or usual care; analyzed using mixed models and qualitative methods.

Main Results:

• Participants attended 6/12 sessions on average; 89% would repeat the intervention.
• 86% reported clinically relevant pain improvement with interventions vs. 20% in usual care (P < .001).
• Qualitative data highlighted access barriers and social benefits of group-based care.

Conclusions:

• Group-based integrative pain management is feasible and acceptable when integrated into safety-net primary care.
• Co-location enhances access to non-pharmacologic pain treatments.
• The findings support further investigation of group-based models for chronic pain in primary care.