A landmark clinical trial has found that an interdisciplinary approach to chronic pain management can significantly reduce pain interference in patients. The wHOPE Randomized Clinical Trial, which included 764 VA patients, tested the VA Whole Health model, a approach that brings together a primary care provider, a clinician trained in non-pharmacologic or integrative pain care, and a wellness coach.
The trial found that participants receiving Whole Health care experienced greater improvements in pain interference than those receiving cognitive behavioral therapy (CBT) and usual care. The Whole Health approach also led to greater engagement in non-drug and complementary and integrative health therapies, including yoga, physical therapy, and acupuncture, which can help patients manage their pain and improve their overall well-being by focusing on physical therapy.
Patients in the Whole Health group reported a better overall perception of their pain over time, as measured by patient-reported global impression of change. Most other secondary outcomes were similar across all groups.
The most striking result was that the Whole Health Team out-performed CBT, a leading evidence-based treatment for chronic pain. Notably, CBT also did not significantly improve outcomes compared with usual care in this study.
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Karen Seal, MD, Chief of Integrative Health Service at San Francisco VA Health Care System, said she is “deeply grateful to the VA clinicians and the more than 750 Veterans nationwide who participated in the wHOPE trial.”
The wHOPE trial was funded by the National Center for Complementary and Integrative Health and is a product of the NIH-DoD-VA Pain Management Collaboratory. The findings are expected to inform future VA pain management guidelines and whole health implementation strategies.
The study’s results have significant implications for the treatment of chronic pain, which affects millions of Veterans. The Whole Health approach addresses not just symptoms but the whole person – a patient’s life, values, and goals.
In terms of numbers, the trial found that participants receiving Whole Health care experienced a significant improvement in pain interference.
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They are continuing to explore new ways to improve the lives of Veterans through innovative research and partnerships with leading academic institutions and industry partners.
The wHOPE trial represents a remarkable step forward in research related to the delivery of the whole health approach, which seeks to empower and equip Veterans to meet their health and well-being goals and live life to the fullest, according to Kavitha P. Reddy, MD, Interim Director of VA’s Office of Patient Centered Care and Cultural Transformation.
It is a step forward.
