MOTIVATE to Improve Outcomes for Older Veterans With Musculoskeletal Pain and Depression

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age60-99
SponsorVA Office of Research and Development

About this trial

The proposed study seeks to evaluate effectiveness, implementation processes, and cost of MOTIVATE among older Veterans with chronic musculoskeletal (MSK) pain and comorbid depressive symptoms.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Aged 60 and older

English- speaking

Self-reported MSK pain (include cLBP +/- radiating symptoms, OA, fibromyalgia) on most days for the past 3 months that interferes with daily activities

Pain intensity that is 4+/10 on the numerical pain rating scale

Disqualifiers

Aged 59 or less

No telephone

Not English speaking

Unwilling to be randomized to either study arm

Trial design

Design model

Parallel

Treatments tested in this trial

  • Behavioral Intervention Group (MOTIVATE)

    Behavioral

    Behavioral: Behavioral Intervention Group (MOTIVATE) The behavioral intervention is designed for older Veterans with musculoskeletal pain and depression and will include 8 individual telephone sessions delivered by health coaches (for up to 5 months total), accounting for additional time between sessions (if needed).

Treatment groups

264 Participants
are divided into 2 treatment groups
Group A: Waitlist Control GroupNo intervention 0 interventions
Group B: Behavior Intervention Group (MOTIVATE)Experimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Primary Outcome: Pain interference

Pain interference will be assessed using the interference subscale of the Brief Pain Inventory (BPI) score at 3 months post-baseline or completion of MOTIVATE. Patient-reported pain-related interference (0-10 scale, with higher values indicating more pain) has been shown to be sensitive to change and to have good reliability. A mean between-group difference of 1-point in the primary outcome (change of BPI interference score from baseline to 3 months) is considered a clinically meaningful difference.

Time frame
3 months post baseline or completion of MOTIVATE

Secondary outcomes

1

Depressive symptoms, PHQ-9

Depressive symptom severity will be assessed using the PHQ-9, a validated 9 question instrument used for monitoring and measuring the severity of depression symptoms. A cutoff score of \>10 signifies clinically meaningful symptom burden

Time frame
Baseline, Mid (~5 weeks), End (~3 months) and 6 months
2

Arthritis self-efficacy

Arthritis self-efficacy scale is a 10 point Likert scale that measures the belief or confidence the subject has to perform 8 specific activities or tasks, based on arthritis Scale range 1-10: 1) very uncertain to 10) very certain

Time frame
Baseline, Mid (~5 weeks), End (~3 months) and 6 months
3

Pain Catastrophizing

Pain catastrophizing, a prominent pain behavior construct, can influence response to treatment for chronic musculoskeletal pain. Scale range 0-4: 0 (not at all) to 4 (all the time)

Time frame
Baseline, Mid (~5 weeks), End (~3 months) and 6 months
4

Psychological resilience

Psychological resilience will be measured by Connor-Davidson Resilience Scale (CD-RISC). scale range 0-4: 0 (not at all) to 4 (all the time)

Time frame
Baseline, Mid (~5 weeks), End (~3 months) and 6 months

Other outcomes

Sponsors and contacts

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VA Office of Research and Development

Lead sponsor

Dallas VA Medical Center

Collaborator

Michael E. DeBakey VA Medical Center

Collaborator