Patients Receiving Integrative Medicine Effectiveness Registry (PRIMIER) of the BraveNet practice-based research network: Results of the chronic pain cohort

Background: An increasing number of clinics are providing integrative medicine for chronic pain, creating a need for real-world, practice-based research. Our purpose was to conduct a multi-site prospective, practice-based, observational evaluation of patient reported outcomes in chronic pain patients. Methods: This study took place at seventeen BraveNet Practice Based Research Network integrative medicine clinics. Chronic pain patients receiving personalized, integrative medicine interventions at BraveNet clinics were eligible. Participants completed the Patient Reported Outcomes Measurement Information System-29, Perceived Stress Scale-4, and the Patient Activation Measure at the index/baseline visit and at 2, 4, 6, and 12 months. Diagnostic and billing codes were extracted data from patients’ health records. Linear mixed-model and multi-variate analyses evaluated changes from index visit through 12 months. Results: A total of 4883 patients enrolled, 3658 qualified and 967 of them endorsed chronic pain, completed at least two outcomes at 2 time points, had evaluable electronic health record data, and had at least one integrative medicine visit during the study period. Participants had a mean age of 51.6 years (SD 13.88) and were mostly white (81.8 %), female (78.3 %), educated (≥ college degree: 70.1 %). Significant improvements were observed on all 7 Patient Reported Outcomes Measurement Information System subscales, Perceived Stress Scale, and Patient Activation Measure scores at 12 months. Conclusions: Chronic pain patients receiving care at integrative medicine clinics reported significant improvement over time in multiple domains of pain and quality of life. Future research with more sites and a common set of outcomes would further guide clinical practice. Trial Registration: Clinical Trials.gov