IPMP (Integrated Pain Management Programs)

Project Summary Title and Description

IPMP (Integrated Pain Management Programs)
Pain affects millions of adults. It impacts physical and mental function and is influenced by multiple factors (e.g., age, sex, comorbidities, and psychosocial factors). Optimal pain management should address biopsychosocial aspects of pain. The U.S. Department of Health and Human Services has been directed to evaluate ways to improve Medicare coverage and payment for pain treatment, particularly through formal pain management programs. Our review assesses the effectiveness and harms of pain management programs that address multiple aspects of pain. The intended audiences for this review are the Centers for Medicare & Medicaid Services (CMS) and other stakeholders including clinicians, policymakers, patients, and their caregivers, and researchers. This review is part of the Dr. Todd Graham Pain Management Study and was sponsored by CMS.
Authors of Report
Andrea C. Skelly, Ph.D., M.P.H.; Roger Chou, M.D.; Joseph R. Dettori, Ph.D., M.P.H., M.P.T.; Erika D. Brodt, B.S.; Andrea Diulio-Nakamura, Ph.D.; Kim Mauer, M.D.; Rongwei Fu, Ph.D.; Yun Yu, M.S.; Ngoc Wasson, M.P.H.; Shelby Kantner, B.A.; Shay Stabler-Morris, B.A
Methodology description
Systematic Review
Funding Source

Key Questions

1. What are the effectiveness and harms of integrated or comprehensive pain management programs for Medicare beneficiaries with complex acute/subacute pain or chronic, nonactive cancer pain? Population subgroups of interest include those with disabilities (including ESRD), prior substance use disorder, psychological co-morbidities (including suicidal behaviors), and degree of nociplasticity.
2. Have any of the following factors been evaluated and/or shown to impact outcomes in studies of comprehensive or integrated pain management models? A. Treatment delivery including session formats (group, one-on-one), duration, intensity and frequency of sessions, number of sessions; general structure and scope of sessions; B. Treatment components (e.g., medication review and/or management, including transition from opioid to nonopioid medications; psychological support or mental health services; physical reconditioning, such as physical therapy and occupational therapy; use of complementary and integrative medicine treatments; patient education; use of medical procedures or devices); C. Care provision (i. Care coordination methods or decision support, ii. Provider types involved, iii. Personalization, care pathways); D. Program characteristics (i. Program emphasis/goals, ii. Target population, iii. Referral sources, iv. Staffing characteristics (e.g., turn over)).

Associated Extraction Forms


Associated Studies (each link opens a new tab)

Title Authors Year
Follow-up results from a randomised controlled trial evaluating in- and outpatient pain management programmes. Peters J, G Large R, Elkind G 1992 Jul
The effectiveness of psychological interventions for the rehabilitation of low back pain: a randomized controlled trial evaluation. Altmaier EM, Lehmann TR, Russell DW, Weinstein JN, Kao CF 1992 Jun
A randomised control trial evaluating in- and outpatient pain management programmes. Peters JL, Large RG 1990 Jun
Effectiveness of behavioral therapy for chronic low back pain: a component analysis. Turner JA, Clancy S, McQuade KJ, Cardenas DD 1990 Oct
A controlled study on the outcome of inpatient and outpatient treatment of low back pain. Part III. Long-term follow-up of pain, disability, and compliance. Harkapaa K, Mellin G, Jarvikoski A, Hurri H 1990
A controlled study on the outcome of inpatient and outpatient treatment of low back pain. Part I. Pain, disability, compliance, and reported treatment benefits three months after treatment. Harkapaa K, Jarvikoski A, Mellin G, Hurri H 1989
Team versus non-team outpatient care in rheumatoid arthritis. A comprehensive outcome evaluation including an overall health measure. Ahlmen M, Sullivan M, Bjelle A 1988 Apr
Active treatment programs for patients with chronic low back pain: a prospective, randomized, observer-blinded study. Bendix AF, Bendix T, Ostenfeld S, Bush E, Andersen 1995
Intensive physical and psychosocial training program for patients with chronic low back pain. A controlled clinical trial. Alaranta H, Rytokoski U, Rissanen A, Talo S, Ronnemaa T, Puukka P, Karppi SL, Videman T, Kallio V, Slatis P 1994 Jun 15
Multidisciplinary intensive treatment for chronic low back pain: a randomized, prospective study. Bendix AF, Bendix T, Vaegter K, Lund C, Frolund L, Holm L 1996 Jan-Feb
Inpatient vs. outpatient pain management: results of a randomised controlled trial. de Williams CAC, Richardson PH, Nicholas MK, Pither CE, Harding VR, Ridout KL, Ralphs JA, Richardson IH, Justins DM, Chamberlain JH 1996 Jul
Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one-year follow-up. Bendix AF, Bendix T, Lund C, Kirkbak S, Ostenfeld S 1997 Jun
Incorporation of cognitive-behavioral treatment into the medical care of chronic low back patients: a controlled randomized study in German pain treatment centers. Basler HD, Jakle C, Kroner-Herwig B 1997 Jun
Chronic low back pain rehabilitation programs: a study of the optimum duration of treatment and a comparison of group and individual therapy. (Part 1) Rose MJ, Reilly JP, Pennie B, Bowen-Jones K, Stanley IM, Slade PD 1997 Oct 1
Functional restoration for chronic low back pain. Two-year follow-up of two randomized clinical trials. Bendix AF, Bendix T, Labriola M, Boekgaard P 1998 Mar 15
A prospective, randomized 5-year follow-up study of functional restoration in chronic low back pain patients. Bendix AE, Bendix T, Haestrup C, Busch E 1998
Effects of a cognitive-behavioral pain-management program. Johansson C, Dahl J, Jannert M, Melin L, Andersson G 1998 Oct
Persistent functional and social benefit 5 years after a multidisciplinary arthritis training program. Scholten C, Brodowicz T, Graninger W, Gardavsky I, Pils K, Pesau B, Eggl-Tyl E, Wanivenhaus A, Zielinski CC 1999 Oct
Functional restoration versus outpatient physical training in chronic low back pain: a randomized comparative study. Bendix T, Bendix A, Labriola M, Haestrup C, Ebbehoj N 2000 Oct 1
A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender? Jensen IB, Bergstrom G, Ljungquist T, Bodin L, Nygren AL 2001 Mar
Operant behavioral treatment of fibromyalgia: a controlled study. Thieme K, Gromnica-Ihle E, Flor H 2003 Jun 15
Outpatient cognitive behavioral pain management programs: a randomized comparison of a group-based multidisciplinary versus an individual therapy model. Turner-Stokes L, Erkeller-Yuksel F, Miles A, Pincus T, Shipley M, Pearce S 2003 Jun
Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study. Jousset N, Fanello S, Bontoux L, Dubus V, Billabert C, Vielle B, Roquelaure Y, Penneau-Fontbonne D, Richard I 2004 Mar 1
A trial of an activating intervention for chronic back pain in primary care and physical therapy settings. Von Korff M, Balderson BHK, Saunders K, Miglioretti DL, Lin EHB, Berry S, Moore JE, Turner JA 2005 Feb
The effects of cognitive-behavioral and physical therapy preventive interventions on pain-related sick leave: a randomized controlled trial. Linton SJ, Boersma K, Jansson M, Svard L, Botvalde M 2005 Mar-Apr
The effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia: a randomized controlled trial. Lemstra M, Olszynski WP 2005 Mar-Apr
Increasing days at work using function-centered rehabilitation in nonacute nonspecific low back pain: a randomized controlled trial. Kool JP, Oesch PR, Bachmann S, Knuesel O, Dierkes JG, Russo M, de Bie RA, van den Brandt PA 2005 May
Randomized comparison of a multidisciplinary job-retention vocational rehabilitation program with usual outpatient care in patients with chronic arthritis at risk for job loss. de Buck PD, le Cessie S, van den Hout WB, Peeters AJ, Ronday HK, Westedt ML, Breedveld FC, Vliet Vlieland TP 2005 Oct 15
Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]. Smeets RJ, Vlaeyen JW, Hidding A, Kester AD, van der Heijden GJ, van Geel AC, Knottnerus JA 2006 Jan 20
Multidisciplinary group rehabilitation versus individual physiotherapy for chronic nonspecific low back pain: a randomized trial. Kaapa EH, Frantsi K, Sarna S, Malmivaara A 2006 Feb 15
Effectiveness and cost-effectiveness of adding a cognitive behavioral treatment to the rehabilitation of chronic low back pain. Schweikert B, Jacobi E, Seitz R, Cziske R, Ehlert A, Knab J, Leidl R 2006 Dec
Chronic low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial. Smeets RJEM, Vlaeyen JWS, Hidding A, Kester ADM, van der Heijden GJMG, Knottnerus AJ 2008 Feb
Function-centered rehabilitation increases work days in patients with nonacute nonspecific low back pain: 1-year results from a randomized controlled trial. Kool J, Bachmann S, Oesch P, Knuesel O, Ambergen T, de Bie R, van den Brandt P 2007 Sep
Comparison of a functional restoration program with active individual physical therapy for patients with chronic low back pain: a randomized controlled trial. Roche G, Ponthieux A, Parot-Shinkel E, Jousset N, Bontoux L, Dubus V, Penneau-Fontbonne D, Roquelaure Y, Legrand E, Colin D, Richard I, Fanello S 2007 Oct
Exposure in vivo versus operant graded activity in chronic low back pain patients: results of a randomized controlled trial. Leeuw M, Goossens MEJB, van Breukelen GJP, de Jong JR, Heuts PHTG, Smeets RJEM, Koke AJA, Vlaeyen JWS 2008 Aug 15
Rationale, design, and baseline findings from a randomized trial of collaborative care for chronic musculoskeletal pain in primary care. Dobscha SK, Corson K, Leibowitz RQ, Sullivan MD, Gerrity MS 2008 Nov
A randomized study of back school in women with chronic low back pain: quality of life at three, six, and twelve months follow-up. Tavafian SS, Jamshidi AR, Montazeri A 2008 Jul 1
Collaborative care for chronic pain in primary care: a cluster randomized trial. Dobscha SK, Corson K, Perrin NA, Hanson GC, Leibowitz RQ, Doak MN, Dickinson KC, Sullivan MD, Gerrity MS 2009 Mar 25
Evaluation of a behavioral-medical inpatient rehabilitation treatment including booster sessions: a randomized controlled study. Mangels M, Schwarz S, Worringen U, Holme M, Rief W 2009 Jun
VA healthcare costs of a collaborative intervention for chronic pain in primary care. Dickinson KC, Sharma R, Duckart JP, Corson K, Gerrity MS, Dobscha SK 2010 Jan
Early intervention options for acute low back pain patients: a randomized clinical trial with one-year follow-up outcomes. Whitfill T, Haggard R, Bierner SM, Pransky G, Hassett RG, Gatchel RJ 2010 Jun
Tailored cognitive-behavioral therapy and exercise training for high-risk patients with fibromyalgia. van Koulil S, van Lankveld W, Kraaimaat FW, van Helmond T, Vedder A, van Hoorn H, Donders R, de Jong AJ, Haverman JF, Korff KJ, van Riel PL, Cats HA, Evers AW 2010 Oct
Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial. Henchoz Y, de Goumoens P, So AK, Paillex R 2010
Multidisciplinary intensive functional restoration versus outpatient active physiotherapy in chronic low back pain: a randomized controlled trial. Roche-Leboucher G, Petit-Lemanac'h A, Bontoux L, Dubus-Bausiere V, Parot-Shinkel E, Fanello S, Penneau-Fontbonne D, Fouquet N, Legrand E, Roquelaure Y, Richard I 2011 Dec 15
Treatment of chronic low back pain: a randomized clinical trial comparing multidisciplinary group-based rehabilitation program and oral drug treatment with oral drug treatment alone. Tavafian SS, Jamshidi AR, Mohammad K 2011 Nov-Dec
Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia. van Koulil S, van Lankveld W, Kraaimaat FW, van Helmond T, Vedder A, van Hoorn H, Donders AR, Wirken L, Cats H, van Riel PL, Evers AW 2011 Dec
Cognitive behavior therapy, exercise, or both for treating chronic widespread pain. McBeth J, Prescott G, Scotland G, Lovell K, Keeley P, Hannaford P, McNamee P, Symmons DP, Woby S, Gkazinou C, Beasley M, Macfarlane GJ 2012 Jan 9
Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: a 1-year randomized controlled trial. Abbasi M, Dehghani M, Keefe FJ, Jafari H, Behtash H, Shams J 2012 Aug
Improved quality of life, working ability, and patient satisfaction after a pretreatment multimodal assessment method in patients with mixed chronic muscular pain: a randomized-controlled study. Rothman MG, Ortendahl M, Rosenblad A, Johansson AC 2013 Mar
Efficacy of a multidisciplinary fibromyalgia treatment adapted for women with low educational levels: a randomized controlled trial. Castel A, Fontova R, Montull S, Perinan R, Poveda MJ, Miralles I, Cascon-Pereira R, Hernandez P, Aragones N, Salvat I, Castro S, Monterde S, Padrol A, Sala J, Anez C, Rull M 2013 Mar
Challenges in demonstrating the effectiveness of multidisciplinary treatment on quality of life, participation and health care utilisation in patients with fibromyalgia: a randomised controlled trial. van Eijk-Hustings Y, Kroese M, Tan F, Boonen A, Bessems-Beks M, Landewe R 2013 Feb
A pilot randomized controlled trial of an early multidisciplinary model to prevent disability following traumatic injury. Browne AL, Appleton S, Fong K, Wood F, Coll F, de Munck S, Newnham E, Schug SA 2013 Jul
Group interprofessional chronic pain management in the primary care setting: a pilot study of feasibility and effectiveness in a family health team in Ontario. Angeles RN, Guenter D, McCarthy L, Bauer M, Wolfson M, Chacon M, Bullock L 2013 Sep-Oct
Effects of intensified work-related multidisciplinary rehabilitation on occupational participation: a randomized-controlled trial in patients with chronic musculoskeletal disorders. Streibelt M, Bethge M 2014 Mar
Interdisciplinary treatment of patients with fibromyalgia: improvement of their health-related quality of life. Martin J, Torre F, Padierna A, Aguirre U, Gonzalez N, Matellanes B, Quintana JM 2014 Nov
Evaluation of the interdisciplinary PSYMEPHY treatment on patients with fibromyalgia: a randomized control trial. Martin J, Torre F, Aguirre U, Gonzalez N, Padierna A, Matellanes B, Quintana JM 2014 Apr
Treatment of low back pain: randomized clinical trial comparing a multidisciplinary group-based rehabilitation program with oral drug treatment up to 12 months. Tavafian SS, Jamshidi AR, Mohammad K 2014 Feb
Interdisciplinary rehabilitation of patients with chronic widespread pain: primary endpoint of the randomized, nonblinded, parallel-group IMPROvE trial. Amris K, Waehrens EE, Christensen R, Bliddal H, Danneskiold-Samsoe B 2014 Jul
Impact of interdisciplinary treatment on physical and psychosocial parameters in patients with fibromyalgia: results of a randomised trial. Martin J, Torre F, Padierna A, Aguirre U, Gonzalez N, Matellanes B, Quintana JM 2014 May
Body mass index and response to a multidisciplinary treatment of fibromyalgia. Castel A, Castro S, Fontova R, Poveda MJ, Cascon-Pereira R, Montull S, Padrol A, Qanneta R, Rull M 2015 Feb
Improving the Multidisciplinary Treatment of Chronic Pain by Stimulating Body Awareness: A Cluster-randomized Trial. Van der Maas LC, Koke A, Pont M, Bosscher RJ, Twisk JW, Janssen TW, Peters ML 2015 Jul
Treatment of low back pain: First extended follow up of an original trial (NCT00600197) comparing a multidisciplinary group-based rehabilitation program with oral drug treatment alone up to 24 months. Tavafian SS, Jamshidi AR, Shay B 2017 Dec
Treatment of low back pain: Second extended follow up of an original trial (NCT00600197) comparing a multidisciplinary group-based rehabilitation program with oral drug treatment alone up to 30 months. Tavafian SS, Jamshidi AR, Mohammad K 2017 Dec
Resource utilisation and direct costs in patients with recently diagnosed fibromyalgia who are offered one of three different interventions in a randomised pragmatic trial. van Eijk-Hustings Y, Kroese M, Creemers A, Landewe R, Boonen A 2016 May
Patient-reported improvements in health are maintained 2 years after completing a short course of cognitive behaviour therapy, exercise or both treatments for chronic widespread pain: long-term results from the MUSICIAN randomised controlled trial. Beasley M, Prescott GJ, Scotland G, McBeth J, Lovell K, Keeley P, Hannaford PC, Symmons DP, MacDonald RI, Woby S, Macfarlane GJ 2015
A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial. Allen KD, Yancy WS Jr, Bosworth HB, Coffman CJ, Jeffreys AS, Datta SK, McDuffie J, Strauss JL, Oddone EZ 2016 Jan 19
The effects of long- and short-term interdisciplinary treatment approaches in women with fibromyalgia: a randomized controlled trial. Saral I, Sindel D, Esmaeilzadeh S, Sertel-Berk HO, Oral A 2016 Oct
Functional status, physical activity level, and exercise regularity in patients with fibromyalgia after Multidisciplinary treatment: retrospective analysis of a randomized controlled trial. Salvat I, Zaldivar P, Monterde S, Montull S, Miralles I, Castel A 2017 Mar
Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial. Allen KD, Oddone EZ, Coffman CJ, Jeffreys AS, Bosworth HB, Chatterjee R, McDuffie J, Strauss JL, Yancy WS Jr, Datta SK, Corsino L, Dolor RJ 2017 Mar 21
Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial. Calner T, Nordin C, Eriksson MK, Nyberg L, Gard G, Michaelson P 2017 Jul
Efficiency of three treatment strategies on occupational and quality of life impairments for chronic low back pain patients: is the multidisciplinary approach the key feature to success? Ronzi Y, Roche-Leboucher G, Begue C, Dubus V, Bontoux L, Roquelaure Y, Richard I, Petit A 2017 Oct
Dosage of pain rehabilitation programmes for patients with chronic musculoskeletal pain: a non-inferiority randomised controlled trial. Reneman MF, Waterschoot FPC, Burgerhof JGM, Geertzen JHB, Schiphorst Preuper HR, Dijkstra PU 2020 Mar
Reboot Online: A Randomized Controlled Trial Comparing an Online Multidisciplinary Pain Management Program with Usual Care for Chronic Pain. Smith J, Faux SG, Gardner T, Hobbs MJ, James MA, Joubert AE, Kladnitski N, Newby JM, Schultz R, Shiner CT, Andrews G 2019 Dec 1
Feasibility and results of a randomised pilot-study of a work rehabilitation programme K. Meyer, J. Fransen, H. Huwiler, D. Uebelhart and A. Klipstein 2005
Mechanism of change following multidisciplinary treatment of low back pain secondary to lumbar disc prolapse I. Onac, A. Moldovan, R. Igna, R. Ungur and I. Onac 2017
Medication, physiotherapy and cognitive behavior therapy for the treatment of chronic back pain: a clinical trial I. Onac, A. Moldovan, I. Onac, R. Igna and L. Pop 2012
Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial Mas, Romina Raczy, Lpez-Jimnez, Toms, Pujol-Ribera, Enriqueta, Fernndez-San Martn, Mara Isabel, Moix-Queralt, Jenny, Montiel-Morillo, Elena, Rodrguez-Blanco, Teresa, Casajuana-Closas, Marc, Gonzlez-Moneo, Maria J, Jurez, Ester Nez 2019
Aging back clinicsA geriatric syndrome approach to treating chronic low back pain in older adults: Results of a preliminary randomized controlled trial Weiner, Debra K, Gentili, Angela, Rossi, Michelle, Coffey-Vega, Katherine, Rodriguez, Keri L, Hruska, Kristina L, Hausmann, Leslie, Perera, Subashan 2020
Chronic low back pain rehabilitation programs: a study of the optimum duration of treatment and a comparison of group and individual therapy. (Part 2) Rose, Michael J, Reilly, James P, Pennie, Bruce, Bowen-Jones, Kim, Stanley, Ian M, Slade, Peter D 1997

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