VETERANS AFFAIRS AUGUSTA

Evaluating the Effectiveness of a Text/Telephone-Delivered Chatbot Intervention for Chronic Pain Management Among High- Utilizing Veterans

Chronic pain is a prevalent and debilitating condition among Veterans, often accompanied by depression, anxiety, sleep disturbances, and social isolation. Despite the availability of behavioral interventions many Veterans-particularly those with high in-person healthcare utilization-face barriers to accessing non-pharmacological pain management strategies. These barriers include limited clinician availability, geographic constraints, and digital exclusion among older or underserved populations.

This study aims to evaluate the feasibility, acceptability, and preliminary impact of My AI Companion, an automated, text/telephone-delivered chatbot designed to support chronic pain self-management among high-utilizing Veterans. The intervention offers a low-barrier approach to promoting symptom tracking, patient activation, and engagement in coping strategies-without requiring Internet access or clinician time.

Inclusion Criteria:Participants must meet all of the following eligibility criteria to be enrolled in the study:

• Be a Veteran receiving care at the VA Augusta Health Care System Pain Medicine Service.
• Be aged 18 or older.
• Have a documented diagnosis of chronic pain (defined as pain persisting longer than 3 months).
• Be classified as a high utilizer of VA in-person outpatient services, defined as having 4 or more in-person primary care, behavioral health, or pain-related visits within the past 6 months.
• Be English-speaking.
• Have access to a telephone (landline or cell phone).
• Have capacity to provide informed consent.

Exclusion Criteria:

• Individuals will be excluded from the study if they:

  • Have moderate to severe cognitive impairment that would interfere with the ability to engage with a text/telephone-based chatbot (as determined through medical record review or clinical judgment).
  • Have active psychosis or acute psychiatric instability (e.g., recent psychiatric hospitalization in the past month) that would impair study participation.
  • Are enrolled in another conflicting behavioral intervention study.
  • Are non-English speaking, due to the current availability of the chatbot only in English.