A SMART design to determine the optimal treatment of chronic pain among military personnel

Contemporary Clinical Trials
Diane FlynnArdith Z Doorenbos

Abstract

Chronic pain is a leading cause of disability among active duty service members in the U.S. armed forces. Standard rehabilitative care and complementary and integrative health therapies are used for chronic pain rehabilitation. However, the optimal sequence and duration of these therapies has yet to be determined. This article describes a sequential multiple assignment randomized trial (SMART) protocol being used to identify the optimal components and sequence of standard rehabilitative care and complementary and integrative health therapies for reducing pain impact and improving other patient outcomes. Active duty service members referred to Madigan Army Medical Center for treatment of chronic pain are being recruited to the Determinants of the Optimal Dose and Sequence of Functional Restoration and Integrative Therapies study. Study participants are randomized to either standard rehabilitative care (physical and occupational therapy and psychoeducation) or complementary and integrative health therapies (chiropractic, acupuncture, yoga and psychoeducation). Those participants who do not respond to the first 3 weeks of treatment are randomized to receive an additional 3 weeks of either (1) the alternative treatment or (2) the f...Continue Reading

Citations

Oct 11, 2019·Research in Nursing & Health·Ardith Z DoorenbosDale Langford
Jun 2, 2020·Japan Journal of Nursing Science : JJNS·Ardith Z Doorenbos, Yutaka Kato
Jan 16, 2021·Arthritis Research & Therapy·Daniel H SolomonFredrik D Johansson
Sep 24, 2021·Statistical Methods in Medical Research·Andrea Morciano, Mirjam Moerbeek

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