<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04403295</url>
  </required_header>
  <id_info>
    <org_study_id>IIR 19-469</org_study_id>
    <nct_id>NCT04403295</nct_id>
  </id_info>
  <brief_title>Collaborative Specialty Care for Gulf War Illness</brief_title>
  <official_title>Collaborative Specialty Care for Gulf War Illness</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>VA Office of Research and Development</agency>
      <agency_class>U.S. Fed</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>VA Office of Research and Development</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      Gulf War Veterans (GWVs) with Gulf War Illness (GWI) do not receive the care they should in&#xD;
      the Veterans Affairs (VA). The investigators' data show 70% of GWVs with Gulf War Illness&#xD;
      (GWI) do not receive treatment recommendations for their GWI and 78% are NOT very satisfied&#xD;
      with their care. The quality of care GWVs receive must improve. VA and DoD have invested&#xD;
      hundreds of millions of dollars to develop new treatments for GWVs, without effective&#xD;
      delivery methods GWVs will not benefit. This study will be the first study to examine the&#xD;
      best model of care to deliver treatments to GWVs with GWI. Determining the best model of care&#xD;
      to translate research into practice is a key goal of the VA Gulf War Strategic Plan and a&#xD;
      specific aim of this Request for Applications.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      There is a quality chasm between the care Gulf War Veterans (GWVs) should receive and the&#xD;
      care they do receive. The investigators' data show 70% of GWVs with Gulf War Illness (GWI) do&#xD;
      not receive treatment recommendations for their GWI and 78% are NOT very satisfied with their&#xD;
      care. Reducing this quality chasm is essential. The VA and DoD have invested hundreds of&#xD;
      millions of dollars to develop new treatments, including the second largest clinical trial&#xD;
      for GWVs which is finding health coaching and problem-solving treatment both reduce the&#xD;
      disability of GWI. Without effective models of healthcare to implement these treatments, GWVs&#xD;
      will not benefit. In the current model of care, GWVs receive care locally through VA's&#xD;
      primary care patient aligned care teams (PACTs). The VA War Related Illness and Injury Study&#xD;
      Center (WRIISC) supports the current model of care by increasing local knowledge of the&#xD;
      skills and treatments needed to manage GWI through national education efforts and electronic&#xD;
      consultation (e-consultation) on difficult cases. The WRIISC and other stakeholders are&#xD;
      currently questioning whether improving local knowledge of skills and treatments for GWI is&#xD;
      enough to address the quality chasm, or if GWI is too complex to be treated in primary care&#xD;
      without additional support from specialists in GWI. A potentially useful model of care for&#xD;
      GWI is collaborative specialty care where specialists work with PACTs to synergistically&#xD;
      treat patients. The local PACT is the lead of the team with the specialist providing some&#xD;
      direct care to the patient (through tele-health) and also consulting with the PACT about&#xD;
      other aspects of care. Collaborative specialty care is effective for other complex conditions&#xD;
      (e.g., depression) with over 40 studies documenting its efficacy. The goal of this proposal&#xD;
      is to conduct a hybrid type 1 randomized effectiveness/implementation trial for GWVs with GWI&#xD;
      (n=220). The primary aim is to determine the effectiveness of tele-CSC as compared to&#xD;
      e-consultation. In tele-CSC, the investigators' specialty provider team will deliver health&#xD;
      coaching and problem-solving treatment to GWVs and recommend the PACT make monthly&#xD;
      optimization of analgesics. In e-consultation the specialty provider team will make a onetime&#xD;
      recommendation to the PACT that the GWV locally receive health coaching and problem-solving&#xD;
      treatment and analgesic optimization. The secondary aim is to understand implementation&#xD;
      outcomes. This information will be used to guide a future randomized (by VISN) multi-site&#xD;
      implementation study. Throughout, an advisory committee of operations partners will be&#xD;
      convened to ensure that the results of the study are able to directly and immediately improve&#xD;
      care. Determining the best model of care to translate research into practice for GWVs with&#xD;
      GWI is a key goal of the VA Gulf War Strategic Plan and a specific aim of this Request for&#xD;
      Applications.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">August 24, 2020</start_date>
  <completion_date type="Anticipated">May 31, 2025</completion_date>
  <primary_completion_date type="Anticipated">March 28, 2025</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <intervention_model_description>In collaborative specialty care the specialty provider team will deliver health coaching and problem-solving treatment to GWVs and recommend the primary care team make monthly optimization of analgesics</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Double (Investigator, Outcomes Assessor)</masking>
    <masking_description>The study coordinator conducting the randomization and study providers will not be blinded. Other staff and investigators (including the Principal Investigator) will be blind to study assignment.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Roland Morris Disability Scale</measure>
    <time_frame>6 months</time_frame>
    <description>Pain disability will be assessed with the RMDS a 24 item scale of disability from pain. The RMDS is a core outcome measure for patients with chronic pain. A change of 2-3 points is considered clinically significant. Pain is present in 99% of GWVs with GWI and previous collaborative care trials in the VA have used this measure. Scores range from 0-24 with higher scores = greater disability.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>World Health Organization Disability Schedule</measure>
    <time_frame>6 months</time_frame>
    <description>The WHO-DAS 2.0 measures disability which is due to physical and mental health conditions. The WHO-DAS 2.0 is a 40 item measure that assesses 6 life tasks. The composite score will be used as the dependent variable. The items of the WHO-DAS have a factor loading on composite score of 0.82 to 0.98. The WHO-DAS was the primary outcome in our previous trial of problem-solving treatment and captures all over health disability. Scores range from 0-100 with higher scores equaling greater disability.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Brief Pain Inventory - Interference Scale</measure>
    <time_frame>6 months</time_frame>
    <description>The 7 item scale measures pain interference on mood, physical activity, social activity and other life activities. A one-point change is clinically significant. Scores range from 0-10 with higher scores equaling greater pain interference.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patient Health Questionnaire Somatic Symptom Scale - 15</measure>
    <time_frame>6 months</time_frame>
    <description>The PHQ-15 captures somatic symptoms. The PHQ-15 was validated on a sample of 6,000 and found to be reliable, valid and responsive to change. Scores range from 0-30 and higher scores are greater symptom severity.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patient Activation Measure</measure>
    <time_frame>6 months</time_frame>
    <description>The PAM is a 13 item self-report measure of the patient's active engagement in self-management their health. The PAM is reliable and valid. Scores range from 0-100 with higher scores indicating greater activation.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Satisfaction: Patient Satisfaction Questionnaire</measure>
    <time_frame>6 month</time_frame>
    <description>The PSQ-III is a 50-item self-report measure with 7 subscales reliability with ranges from .77-.89. The investigators will use the composite score. Score range from 0-100 with higher scores indicating greater satisfaction.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Roland Morris Disability Scale</measure>
    <time_frame>9 month</time_frame>
    <description>Pain disability will be assessed with the RMDS a 24 item scale of disability from pain. The RMDS is a core outcome measure for patients with chronic pain. A change of 2-3 points is considered clinically significant. Pain is present in 99% of GWVs with GWI and previous collaborative care trials in the VA have used this measure. Scores range from 0-24 with higher scores = greater disability.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>World Health Organization Disability Schedule</measure>
    <time_frame>9 month</time_frame>
    <description>The WHO-DAS 2.0 measures disability which is due to physical and mental health conditions. The WHO-DAS 2.0 is a 40 item measure that assesses 6 life tasks. The composite score will be used as the dependent variable. The items of the WHO-DAS have a factor loading on composite score of 0.82 to 0.98. The WHO-DAS was the primary outcome in our previous trial of problem-solving treatment and captures all over health disability. Scores range from 0-100 with higher scores equaling greater disability.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Brief Pain Inventory - Interference Scale</measure>
    <time_frame>9 month</time_frame>
    <description>The 7 item scale measures pain interference on mood, physical activity, social activity and other life activities. A one-point change is clinically significant. Scores range from 0-10 with higher scores equaling greater pain interference.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patient Health Questionnaire Somatic Symptom Scale - 15</measure>
    <time_frame>9 month</time_frame>
    <description>The PHQ-15 captures somatic symptoms. The PHQ-15 was validated on a sample of 6,000 and found to be reliable, valid and responsive to change. Scores range from 0-30 and higher scores are greater symptom severity.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patient Activation Measure</measure>
    <time_frame>9 month</time_frame>
    <description>The PAM is a 13 item self-report measure of the patient's active engagement in self-management their health. The PAM is reliable and valid. Scores range from 0-100 with higher scores indicating greater activation.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Satisfaction: Patient Satisfaction Questionnaire</measure>
    <time_frame>9 month</time_frame>
    <description>The PSQ-III is a 50-item self-report measure with 7 subscales reliability with ranges from .77-.89. The investigators will use the composite score. Score range from 0-100 with higher scores indicating greater satisfaction.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">220</enrollment>
  <condition>Gulf War Illness</condition>
  <arm_group>
    <arm_group_label>collaborative specialty care</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>In specialty collaborative care, the specialty provider team will deliver health coaching and problem-solving treatment to GWVs and recommend the primary care team make monthly optimization of analgesics.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>e-consultation</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>In e-consultation the specialty provider team will make a onetime recommendation to the primary care team that the GWV locally receive health coaching and problem-solving treatment and analgesic optimization.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Collaborative Specialty Care</intervention_name>
    <description>In specialty collaborative care, the specialty provider team will deliver health coaching and problem-solving treatment to GWVs and recommend the primary care team make monthly optimization of analgesics.</description>
    <arm_group_label>collaborative specialty care</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>e-consultation</intervention_name>
    <description>In e-consultation the specialty provider team will make a onetime recommendation to the primary care team that the GWV locally receive health coaching and problem-solving treatment and analgesic optimization.</description>
    <arm_group_label>e-consultation</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  deployed to Operation Desert Shield/Storm&#xD;
&#xD;
          -  meets Kansas City (Steele) definition of GWI (which excludes conditions that may&#xD;
             account for GWI)&#xD;
&#xD;
          -  rates their activity limitations from pain at least 3 on a 0 to 10 point scale&#xD;
&#xD;
          -  has a VA primary care provider&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  suicidal intent&#xD;
&#xD;
          -  previous evaluation at the WRIISC or participated in our clinical trial for GWVs with&#xD;
             GWI&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Lisa Marie McAndrew, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>East Orange Campus of the VA New Jersey Health Care System, East Orange, NJ</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Justeen K Hyde, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>VA Bedford HealthCare System, Bedford, MA</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Scott E. Sherman, MD MPH</last_name>
    <role>Principal Investigator</role>
    <affiliation>Manhattan Campus of the VA NY Harbor Healthcare System, New York, NY</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Lisa M McAndrew, PhD</last_name>
    <phone>(862) 400-3317</phone>
    <email>Lisa.Mcandrew@va.gov</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Nicole Whittaker, MSW</last_name>
    <phone>(973) 676-1000</phone>
    <phone_ext>201167</phone_ext>
    <email>nicole.whittaker2@va.gov</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>East Orange Campus of the VA New Jersey Health Care System, East Orange, NJ</name>
      <address>
        <city>East Orange</city>
        <state>New Jersey</state>
        <zip>07018</zip>
        <country>United States</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Carmelen B Chiusano, MPA</last_name>
      <phone>(973) 676-1000</phone>
      <phone_ext>2220</phone_ext>
      <email>carmelen.chiusano@va.gov</email>
    </contact>
    <contact_backup>
      <last_name>Kevin D Beck, PhD</last_name>
      <phone>(973) 676-1000</phone>
      <email>Kevin.Beck@va.gov</email>
    </contact_backup>
    <investigator>
      <last_name>Lisa Marie McAndrew, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <verification_date>December 2022</verification_date>
  <study_first_submitted>May 20, 2020</study_first_submitted>
  <study_first_submitted_qc>May 20, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">May 27, 2020</study_first_posted>
  <last_update_submitted>December 21, 2022</last_update_submitted>
  <last_update_submitted_qc>December 21, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">December 23, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Veteran</keyword>
  <keyword>Gulf War Illness</keyword>
  <keyword>implementation</keyword>
  <keyword>Chronic Pain</keyword>
  <keyword>health coaching</keyword>
  <keyword>problem-solving</keyword>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04403295
org study id: IIR 19-469
nct id: NCT04403295
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
is us export: No
Gulf War Veterans (GWVs) with Gulf War Illness (GWI) do not receive the care they should in
      the Veterans Affairs (VA). The investigators' data show 70% of GWVs with Gulf War Illness
      (GWI) do not receive treatment recommendations for their GWI and 78% are NOT very satisfied
      with their care. The quality of care GWVs receive must improve. VA and DoD have invested
      hundreds of millions of dollars to develop new treatments for GWVs, without effective
      delivery methods GWVs will not benefit. This study will be the first study to examine the
      best model of care to deliver treatments to GWVs with GWI. Determining the best model of care
      to translate research into practice is a key goal of the VA Gulf War Strategic Plan and a
      specific aim of this Request for Applications.
There is a quality chasm between the care Gulf War Veterans (GWVs) should receive and the
      care they do receive. The investigators' data show 70% of GWVs with Gulf War Illness (GWI) do
      not receive treatment recommendations for their GWI and 78% are NOT very satisfied with their
      care. Reducing this quality chasm is essential. The VA and DoD have invested hundreds of
      millions of dollars to develop new treatments, including the second largest clinical trial
      for GWVs which is finding health coaching and problem-solving treatment both reduce the
      disability of GWI. Without effective models of healthcare to implement these treatments, GWVs
      will not benefit. In the current model of care, GWVs receive care locally through VA's
      primary care patient aligned care teams (PACTs). The VA War Related Illness and Injury Study
      Center (WRIISC) supports the current model of care by increasing local knowledge of the
      skills and treatments needed to manage GWI through national education efforts and electronic
      consultation (e-consultation) on difficult cases. The WRIISC and other stakeholders are
      currently questioning whether improving local knowledge of skills and treatments for GWI is
      enough to address the quality chasm, or if GWI is too complex to be treated in primary care
      without additional support from specialists in GWI. A potentially useful model of care for
      GWI is collaborative specialty care where specialists work with PACTs to synergistically
      treat patients. The local PACT is the lead of the team with the specialist providing some
      direct care to the patient (through tele-health) and also consulting with the PACT about
      other aspects of care. Collaborative specialty care is effective for other complex conditions
      (e.g., depression) with over 40 studies documenting its efficacy. The goal of this proposal
      is to conduct a hybrid type 1 randomized effectiveness/implementation trial for GWVs with GWI
      (n=220). The primary aim is to determine the effectiveness of tele-CSC as compared to
      e-consultation. In tele-CSC, the investigators' specialty provider team will deliver health
      coaching and problem-solving treatment to GWVs and recommend the PACT make monthly
      optimization of analgesics. In e-consultation the specialty provider team will make a onetime
      recommendation to the PACT that the GWV locally receive health coaching and problem-solving
      treatment and analgesic optimization. The secondary aim is to understand implementation
      outcomes. This information will be used to guide a future randomized (by VISN) multi-site
      implementation study. Throughout, an advisory committee of operations partners will be
      convened to ensure that the results of the study are able to directly and immediately improve
      care. Determining the best model of care to translate research into practice for GWVs with
      GWI is a key goal of the VA Gulf War Strategic Plan and a specific aim of this Request for
      Applications.
allocation: Randomized
intervention model: Parallel Assignment
intervention model description: In collaborative specialty care the specialty provider team will deliver health coaching and problem-solving treatment to GWVs and recommend the primary care team make monthly optimization of analgesics
primary purpose: Treatment
masking: Double (Investigator, Outcomes Assessor)
masking description: The study coordinator conducting the randomization and study providers will not be blinded. Other staff and investigators (including the Principal Investigator) will be blind to study assignment.
measure: Roland Morris Disability Scale
time frame: 6 months
description: Pain disability will be assessed with the RMDS a 24 item scale of disability from pain. The RMDS is a core outcome measure for patients with chronic pain. A change of 2-3 points is considered clinically significant. Pain is present in 99% of GWVs with GWI and previous collaborative care trials in the VA have used this measure. Scores range from 0-24 with higher scores = greater disability.
measure: World Health Organization Disability Schedule
time frame: 6 months
description: The WHO-DAS 2.0 measures disability which is due to physical and mental health conditions. The WHO-DAS 2.0 is a 40 item measure that assesses 6 life tasks. The composite score will be used as the dependent variable. The items of the WHO-DAS have a factor loading on composite score of 0.82 to 0.98. The WHO-DAS was the primary outcome in our previous trial of problem-solving treatment and captures all over health disability. Scores range from 0-100 with higher scores equaling greater disability.
measure: Brief Pain Inventory - Interference Scale
time frame: 6 months
description: The 7 item scale measures pain interference on mood, physical activity, social activity and other life activities. A one-point change is clinically significant. Scores range from 0-10 with higher scores equaling greater pain interference.
measure: Patient Health Questionnaire Somatic Symptom Scale - 15
time frame: 6 months
description: The PHQ-15 captures somatic symptoms. The PHQ-15 was validated on a sample of 6,000 and found to be reliable, valid and responsive to change. Scores range from 0-30 and higher scores are greater symptom severity.
measure: Patient Activation Measure
time frame: 6 months
description: The PAM is a 13 item self-report measure of the patient's active engagement in self-management their health. The PAM is reliable and valid. Scores range from 0-100 with higher scores indicating greater activation.
measure: Satisfaction: Patient Satisfaction Questionnaire
time frame: 6 month
description: The PSQ-III is a 50-item self-report measure with 7 subscales reliability with ranges from .77-.89. The investigators will use the composite score. Score range from 0-100 with higher scores indicating greater satisfaction.
measure: Roland Morris Disability Scale
time frame: 9 month
description: Pain disability will be assessed with the RMDS a 24 item scale of disability from pain. The RMDS is a core outcome measure for patients with chronic pain. A change of 2-3 points is considered clinically significant. Pain is present in 99% of GWVs with GWI and previous collaborative care trials in the VA have used this measure. Scores range from 0-24 with higher scores = greater disability.
measure: World Health Organization Disability Schedule
time frame: 9 month
description: The WHO-DAS 2.0 measures disability which is due to physical and mental health conditions. The WHO-DAS 2.0 is a 40 item measure that assesses 6 life tasks. The composite score will be used as the dependent variable. The items of the WHO-DAS have a factor loading on composite score of 0.82 to 0.98. The WHO-DAS was the primary outcome in our previous trial of problem-solving treatment and captures all over health disability. Scores range from 0-100 with higher scores equaling greater disability.
measure: Brief Pain Inventory - Interference Scale
time frame: 9 month
description: The 7 item scale measures pain interference on mood, physical activity, social activity and other life activities. A one-point change is clinically significant. Scores range from 0-10 with higher scores equaling greater pain interference.
measure: Patient Health Questionnaire Somatic Symptom Scale - 15
time frame: 9 month
description: The PHQ-15 captures somatic symptoms. The PHQ-15 was validated on a sample of 6,000 and found to be reliable, valid and responsive to change. Scores range from 0-30 and higher scores are greater symptom severity.
measure: Patient Activation Measure
time frame: 9 month
description: The PAM is a 13 item self-report measure of the patient's active engagement in self-management their health. The PAM is reliable and valid. Scores range from 0-100 with higher scores indicating greater activation.
measure: Satisfaction: Patient Satisfaction Questionnaire
time frame: 9 month
description: The PSQ-III is a 50-item self-report measure with 7 subscales reliability with ranges from .77-.89. The investigators will use the composite score. Score range from 0-100 with higher scores indicating greater satisfaction.
arm group label: collaborative specialty care
arm group type: Experimental
description: In specialty collaborative care, the specialty provider team will deliver health coaching and problem-solving treatment to GWVs and recommend the primary care team make monthly optimization of analgesics.
arm group label: e-consultation
arm group type: Active Comparator
description: In e-consultation the specialty provider team will make a onetime recommendation to the primary care team that the GWV locally receive health coaching and problem-solving treatment and analgesic optimization.
intervention type: Behavioral
intervention name: Collaborative Specialty Care
description: In specialty collaborative care, the specialty provider team will deliver health coaching and problem-solving treatment to GWVs and recommend the primary care team make monthly optimization of analgesics.
arm group label: collaborative specialty care
intervention type: Behavioral
intervention name: e-consultation
description: In e-consultation the specialty provider team will make a onetime recommendation to the primary care team that the GWV locally receive health coaching and problem-solving treatment and analgesic optimization.
arm group label: e-consultation
criteria: 
gender: All
minimum age: N/A
maximum age: N/A
healthy volunteers: No
last name: Lisa Marie McAndrew, PhD
role: Principal Investigator
affiliation: East Orange Campus of the VA New Jersey Health Care System, East Orange, NJ
last name: Justeen K Hyde, PhD
role: Principal Investigator
affiliation: VA Bedford HealthCare System, Bedford, MA
last name: Scott E. Sherman, MD MPH
role: Principal Investigator
affiliation: Manhattan Campus of the VA NY Harbor Healthcare System, New York, NY
last name: Lisa M McAndrew, PhD
phone: (862) 400-3317
email: Lisa.Mcandrew@va.gov
last name: Nicole Whittaker, MSW
phone: (973) 676-1000
phone ext: 201167
email: nicole.whittaker2@va.gov
facility: 
status: Recruiting
contact: 
contact backup: 
investigator: 
country: United States
responsible party type: Sponsor
sharing ipd: No