Approximately 25% of patients following knee arthroplasty have disabling pain following apparently successful surgery. Recent research suggests that pain catastrophizing plays a key role in determining which patients with knee arthroplasty have a poor outcome. In addition to this evidence, a substantial literature suggests that pain coping skills training is effective for patients with chronic pain but the intervention hs not been studied for surgical patients with severe arthritic knee pain. We designed the Knee Arthroplasty pain coping Skills Training (KASTpain) trial to address this research need. This Phase III three-arm randomized clinical trial seeks to combine a strong and diverse group of researchers to examine an important and understudied area in the joint arthroplasty literature. The KASTpain trial will be the first to examine the utility of a perioperative pain coping intervention for this substantial population of patients. The clinical trial grant is designed to met the following specific aims: 1) to determine if a pain coping skills training intervention provided by psychologists is more effective at reducing pain and improving function and is more cost effective than arthritis education or usual care and 2) to determine if changes in pain and function following pain coping skills training are mediated by changes in pain catastrophizing. A tertiary aim will be to determine if pain coping skills training is more cost effective than either arthritis education or usual care. We expect that the study will have a substantial impact on clinical practice by providing evidence in support of a new treatment paradigm;a perioperative pain coping skills training approach for knee arthroplasty patients at-risk for poor outcome.

Public Health Relevance

We expect that the study will have a substantial impact on public health by providing evidence in support of a new treatment paradigm;a perioperative pain coping skills training approach for thousands of knee arthroplasty patients at-risk for poor outcome.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project with Complex Structure Cooperative Agreement (UM1)
Project #
5UM1AR062800-03
Application #
8708498
Study Section
Special Emphasis Panel (ZAR1-CHW (M1))
Program Officer
Lester, Gayle E
Project Start
2012-08-01
Project End
2017-07-31
Budget Start
2014-08-01
Budget End
2015-07-31
Support Year
3
Fiscal Year
2014
Total Cost
$1,109,883
Indirect Cost
$123,487
Name
Virginia Commonwealth University
Department
Other Health Professions
Type
Schools of Allied Health Profes
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Keefe, Francis J; Wren, Anava A (2013) Optimism and pain: a positive move forward. Pain 154:7-8
Keefe, F J; Porter, L; Somers, T et al. (2013) Psychosocial interventions for managing pain in older adults: outcomes and clinical implications. Br J Anaesth 111:89-94