--- title: "Cost-effectiveness of telephone motivational interviewing (MAPS) for veterans with musculoskeletal" id: "bmj-open-11-the-cost-effectiveness-of-motivational-interviewing-to-activate-pain-support-in" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-11-the-cost-effectiveness-of-motivational-interviewing-to-activate-pain-support-in" content_type: "clinical_feed_article" specialty: "General" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/8/e119224?rss=1" published_at: "2026-08-28T09:38:04.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Cost-effectiveness of telephone motivational interviewing (MAPS) for veterans with musculoskeletal ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-11-the-cost-effectiveness-of-motivational-interviewing-to-activate-pain-support-in - **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/8/e119224?rss=1) - **Published At:** 2026-08-28T09:38:04.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - This multisite, pragmatic randomized clinical trial tested a brief telephone-delivered **motivational interviewing** intervention (MAPS) versus usual care in veterans filing service-related musculoskeletal injury claims in New England. - The study included 1,101 enrolled participants; cost-effectiveness analyses used 945 participants (85.8%) with at least one follow-up. - The MAPS intervention comprised a one-hour initial telephone session plus up to four 20-minute follow-ups; per-participant intervention cost was reported as $300. - Costs were measured using VA administrative databases and participant questionnaires; outcomes included healthcare utilization, activity limitations, pain intensity, substance use, and preference-rated quality of life. - MAPS increased use of musculoskeletal services, including greater receipt of physical therapy, spinal manipulation, acupuncture and other outpatient visits. - From the healthcare system perspective, average costs for musculoskeletal care increased by US$1,508 among MAPS participants compared with usual care. - There was no significant difference in total cost from the societal perspective between MAPS and usual care. - MAPS produced a slight reduction in pain intensity over the 36-week trial but did not produce significant improvement in preference-rated quality of life. - Over the 36-week time horizon, MAPS was not cost-effective; the study notes that long-term cost-effectiveness remains unknown. - Some numeric detail in the source text was truncated and not reported in the provided article extract; those specifics are not available here. ## Clinical Analysis & Structured Key Points Objectives We evaluated the cost and cost-effectiveness of brief motivational interviews conducted to facilitate pain and substance use treatment. Design This two-arm parallel group 36-week multi-site randomised pragmatic clinical trial compared the motivational interviewing for pain activation (MAPS) intervention to usual care. Cost was assessed from administrative databases and participant questionnaires. Activity limitations and quality of life were also assessed. Assessment staff were blinded to treatment group assignment. Setting Eight medical centres of the US Department of Veterans Affairs (VA) in the six states in the New England region of the US. Participants Veterans with a New England address who had filed a claim for a service-related musculoskeletal injury reported at least moderately severe pain and could be reached by telephone were invited to participate but were excluded if they were enrolled in another trial, had received more than two types of VA pain services in the prior 12 weeks or were not available for follow-up. There were 1101 participants. Cost-effectiveness was evaluated in 945 trial participants (85.8%) with at least one follow-up assessment. Intervention A 1-hour long telephone-delivered motivational interview designed to engage participants in treatment was followed by up to four 20-min follow-up sessions. Primary and secondary outcome measures Primary outcomes were change in pain intensity and substance use. This paper reports findings from the secondary outcomes of cost-effectiveness and quality of life for the intervention relative to usual care. Results The intervention cost $300 per participant, resulted in significantly greater use of physical therapy, spinal manipulation, acupuncture and other outpatient visits, and increased the cost for the care of musculoskeletal conditions by $US1,508 (p Conclusions The intervention increased use of care for musculoskeletal services, increasing cost from the perspective of the healthcare system. There was no significant difference in cost from the societal perspective. It resulted in a slight reduction in pain but had no significant effect on preference-rated quality of life. MAPS was not cost-effective over the short 36-week time horizon of the trial, but its long-term cost-effectiveness is unknown. Trial registration number NCT04062214 . ## Related Clinical Research - [Nursing undergraduates’ willingness to work in long-term care: qualitative insights from a geriatr](https://medichelpline.com/clinical-feed/plos-one-16-willingness-of-nursing-undergraduates-to-work-in-long-term-care-facilities-a.md) - [Cropland type determines arbuscular mycorrhizal fungi (AMF) density and diversity in Northwest Eth](https://medichelpline.com/clinical-feed/plos-one-23-cropland-type-shapes-arbuscular-mycorrhizal-fungi-amf-population-density-and.md) - [Patient and Public Engagement in Clinical Trials: CTO’s Decade of Co‑production Lessons](https://medichelpline.com/clinical-feed/bmj-open-0-partnering-with-patients-and-the-public-in-the-clinical-trials-ecosystem-a.md) - [Variable-rate feedback versus fixed-rate basal PCA: effect on 48-hour cumulative opioid consumption](https://medichelpline.com/clinical-feed/bmj-open-7-comparison-of-cumulative-opioid-consumption-between-variable-rate-feedback.md) - [FRACTURE-ML: Nationwide machine-learning tool for population hip fracture prediction](https://medichelpline.com/clinical-feed/plos-medicine-2-a-clinical-decision-support-tool-for-accurate-hip-fracture-prediction-a.md) ## Navigation - [← Back to General Feed](https://medichelpline.com/clinical-feed/general.md) - [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md) ## Medical & Regulatory Disclaimer > [!CAUTION] > MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations. > Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.