{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:12:55Z","timestamp":1776132775416,"version":"3.50.1"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Chronic pain after traumatic brain injury (TBI) is prevalent and associated with poor outcomes. By providing multidisciplinary care through expert consultation, a collaborative care (CC) treatment approach may reduce pain interference.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare CC with usual care (UC) in decreasing pain interference.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This randomized clinical trial was conducted from July 2018 through April 2021 at 2 hospital-based academic rehabilitation medicine clinics in Seattle, Washington. Participants included adults with mild-to-severe TBI (at least 6 months before enrollment) and chronic pain. Data analysis was performed from March 30, 2022, to August 30, 2023.<\/jats:p><\/jats:sec>Intervention<\/jats:title>The CC intervention (called TBI Care) included up to 12 in-person or telephone visits over 16 weeks with a care manager (CM) who provided person-centered cognitive behavioral treatment. The CM met weekly with members of the expert team to review participants and discuss recommendations to optimize treatment.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was pain interference on the Brief Pain Inventory at treatment conclusion (4 months after randomization). Secondary outcomes included pain interference at 8 months; pain severity; symptoms of depression, anxiety, and sleep disturbance; pain-related emergency department visits; community participation; and participant satisfaction. Linear mixed-effects regression was used for analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 1379 individuals were screened for eligibility, and 158 were randomized (79 to CC and 79 to UC). The participants were mostly women (92 participants [58%]) with a mean (SD) age of 46.8 (13.2) years and a mean (SD) of 15.3 (3.0) years of education. TBI occurred a mean (SD) of 4.0 (5.9) years (median [IQR], 1.9 [0.8-4.5] years) before enrollment. All TBI severities were included, and of 149 participants for whom TBI severity was known, the majority (97 participants [65%]) had mild TBI. In the CC group, 71 participants (90%) completed at least 11 sessions, and, at 4 months, this group had significantly lower pain interference scores compared with the UC group (mean [SD], 3.46 [2.17] vs 5.03\u2009[2.28]). This difference was maintained at 8 months after randomization, with mean (SD) TBI care pain interference scores of 3.61 (2.22) for CC vs 4.68 (2.51) for UC. At 4 months, there was significantly lower pain severity in the CC group vs UC group (mean [SD] score, 3.63 [1.95] vs 4.90\u2009[1.96]), as well as symptoms of depression (mean [SD] score, 8.07 [5.34] vs 11.31\u2009[6.37]) and anxiety (mean [SD], 6.20 [5.17] vs 9.58 [6.00]). Satisfaction with pain treatment (mean [SD] score, 2.99\u2009[1.23] vs 2.52 [1.25]), clinical care (mean [SD] score, 3.28\u2009[1.00] vs 2.84\u2009[1.26]), and overall health care (mean [SD] score, 3.25 [0.88] vs 2.82 [1.00]) were significantly higher in the CC group vs the UC group; global impression of change was significantly lower in the CC group vs the UC group (mean [SD] score, 2.74 [1.02] vs 3.47\u2009[1.26]) (lower scores denote a better impression of change).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial of CC compared with UC for patients with TBI, CC was effective at reducing pain interference and was sustained at 8-month follow-up. Further research is needed to examine the implementation and cost-effectiveness of CC for TBI in other health care settings.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT03523923<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.13459","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T15:10:53Z","timestamp":1717427453000},"page":"e2413459","source":"Crossref","is-referenced-by-count":13,"title":["Collaborative Care for Chronic Pain After Traumatic Brain Injury"],"prefix":"10.1001","volume":"7","author":[{"given":"Jeanne M.","family":"Hoffman","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Curran","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Washington School of 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