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Motivational Interviewing Targeting Pain and Substance Use in Veterans Seeking Service-Connection Payments: A

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Summary

Motivational Interviewing to Activate Pain Support (MAPS) helped veterans with musculoskeletal disorders (MSDs) increase outpatient visits and reduce pain severity. While not all outcomes reached clinical significance, MAPS showed potential benefits for veterans seeking pain management.

Keywords:
Veteranscompensationcounselingdisabilitymotivational interviewingpainservice-connectionsubstance use

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Area of Science:

  • Health Services Research
  • Behavioral Health
  • Pain Management

Background:

  • Veterans filing musculoskeletal disorder (MSD) claims often require medical treatment.
  • Assessing interventions for pain and substance use in this population is crucial.

Purpose of the Study:

  • To evaluate the impact of Motivational Interviewing to Activate Pain Support (MAPS) on pain and substance use.
  • Focus on post-9/11 veterans with MSD claims and moderate-to-severe pain.

Main Methods:

  • A pragmatic clinical trial involving 1101 veterans with MSD claims.
  • MAPS intervention (up to five phone sessions) compared to treatment-as-usual (TAU).
  • Primary outcomes: pain severity (Brief Pain Inventory) and substance use (ASSIST).

Main Results:

  • MAPS participants showed statistically significant reductions in pain severity at 36 weeks compared to TAU.
  • No significant difference in clinically meaningful pain improvement or substance use between groups.
  • MAPS was associated with a 54% increase in outpatient encounters for MSDs.

Conclusions:

  • MAPS intervention led to increased healthcare utilization for MSDs and reduced pain severity.
  • Potential benefits may stem from patient activation and improved navigation of pain care systems.
  • Further research can explore optimizing MAPS for sustained clinical benefits in veterans.