The following is a summary of the “An Analysis of the Role of Mental Health in a Randomized Trial of a Walking Intervention for Black Veterans With Chronic Pain,” published in the January 2023 issue of Pain Management by Hammett, et al.

Patients of color and those experiencing mental health issues simultaneously are overrepresented in the chronic pain population. However, they are rarely the focus of pain management efforts. This study is a sub-analysis of a larger randomized controlled trial of a proactive counseling intervention emphasizing walking for Black Veterans suffering from persistent musculoskeletal pain (ACTION). The primary objective was to compare the effectiveness of interventions for Veterans who had been diagnosed with a mental health condition (depression, anxiety, substance use disorder, post-traumatic stress, or serious mental illness; n = 205) and those who had not been diagnosed (n = 175) using data from their electronic health records. 

During 2016-2019, about 380 Black Veterans at the Atlanta VA Health Care System were registered and randomly assigned to either the intervention or usual care (UC) (1:1). In addition, 6 telephone coaching sessions were administered over the course of 8-14 weeks as part of the intervention. When comparing UC and participants with a mental health issue, those with the former were more likely to complete all counseling sessions (56% vs. 38%) and to experience reductions in their global perceptions of pain and pain intensity/interference (secondary outcomes) at 3 months. 

The intervention was associated with reduced pain-related impairment at 6 months among participants who did not have a mental health issue (primary outcome). Pain-related impairment in black people with chronic pain and mental health concerns may require more intense therapy. Black Veterans with mental health issues are the focus of this investigation into the efficacy of a walking intervention for chronic pain. Patients with mental health conditions participated more actively in the intervention. However, pain-related impairment did not improve, suggesting that more treatment is required.

Source: sciencedirect.com/science/article/abs/pii/S1526590022003613