Pilot Testing A Theory-Driven Self- Management Intervention for Chronic Musculoskeletal Pain

对慢性肌肉骨骼疼痛的理论驱动的自我管理干预措施进行试点测试

基本信息

批准号：
10437163
负责人：
Jennifer Kawi
金额：
$ 1.38万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-09 至 2021-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10437163
关键词：
Acupressure Acupuncture Therapy Address Adherence Adult Adverse effects American Analgesics Back Belief COVID-19 pandemic Caring Cellular Phone Clinical Trials Computers Diagnosis Ear Ecological momentary assessment Economics Ensure Fright Goals Guidelines Health Health Care Costs Health Personnel Health Services Accessibility Healthcare Systems Individual Inflammatory Institutes Instruction Insurance Interleukin-1 beta Interleukin-2 Intervention Joints Learning Life Maryland Measures Mediating Mediator of activation protein Medical Monitor Motivation Needles Nerve Nevada Obesity Opioid Opioid Analgesics Pain Pain intensity Pain interference Pain management Participant Patient Self-Report Patients Persistent pain Persons Pharmaceutical Preparations Pharmacotherapy Physical Function Physical activity Physiological Pilot Projects Population Heterogeneity Procedures Quality of life Randomized Randomized Clinical Trials Reporting Self Administration Self Efficacy Self Management Site Societies Tablets Technology Testing Therapeutic Time Training Virus Waiting Lists Work base chronic musculoskeletal pain chronic pain clinical Diagnosis clinically significant common treatment comorbidity compliance behavior cost cytokine demographics efficacy evaluation follow-up healing improved non-opioid analgesic novel opioid epidemic opioid use pain outcome pain relief pain self-management preference primary endpoint primary outcome psychologic racial and ethnic satisfaction secondary outcome sex smartphone Application socioeconomic disadvantage theories tool treatment as usual trial comparing usability usual care arm web-enabled

项目摘要

PROJECT SUMMARY Despite a range of therapeutic approaches, chronic musculoskeletal pain (CMP) continues to be a major health issue. It is the most common type of chronic pain, occurring particularly in the joints and back, lasting beyond normal healing (3-6 months). In 2016, 20% of American adults reported chronic pain and 8% of them had limited life activities. Pharmacotherapy is the predominant treatment for chronic pain in current US medical practice, but it has led to the current opioid crisis. Building upon our prior work and lessons learned, we intend to maximize the usability and accessibility of APA. First, we will advance our previous smartphone app by developing a self-guided mobile/web-enabled APA app (mAPA) version on a computer, tablet, or smartphone to allow participants to access APA information based on their preferences and learn to self-administer APA. mAPA will include shortened videos (~1 min) to facilitate micro-learning and incorporate ecological momentary assessment to monitor adherence and capture real-time pain outcomes and analgesic use. Then, we will evaluate the efficacy of mAPA on CMP outcomes through a 3- armed RCT: (1) Self-guided mAPA, (2) In-Person Training + mAPA, and (3) Wait-List Usual Care Control. Participants in the two mAPA groups will continue to receive usual care while participants in the Usual Care Control group will be re-randomized into either mAPA group after 1-month follow-up. Compared to our pilot study, this is a larger scale and longer term RCT to be conducted in Maryland and Nevada ensuring sites that will be inclusive and representative of diverse populations. Our long-term goal is to eliminate pain care disparities and reduce our society’s reliance on opioids to manage pain. Leveraging technology, the proposed study will help advance mAPA, a novel, easy-to-initiate, rapid, safe, and non-pharmacological tool incorporated in a self-management plan to habitually manage pain in real-world settings.

项目摘要尽管采用了各种治疗方法，但慢性肌肉骨骼疼痛（CMP）仍然是一种主要健康状况问题。它是最常见的慢性疼痛类型，特别是在关节和背部，持续正常愈合（3-6个月）。 2016年，有20％的美国成年人报告了慢性疼痛，其中8％的疼痛患有有限的生活活动。药物治疗是当前美国医疗的慢性疼痛的主要治疗方法练习，但这导致了当前的阿片类药物危机。在我们先前的工作和经验教训的基础上，我们打算最大程度地提高APA的可用性和可访问性。首先，我们将通过开发自我引导的移动/Web APA应用程序来推进以前的智能手机应用程序（MAPA）计算机，平板电脑或智能手机上的版本，允许参与者访问APA信息关于他们的偏好并学会自我管理APA。 MAPA将包括缩短视频（〜1分钟）以促进微学习和纳入生态时刻评估，以监测依从性并捕获实时疼痛结局和镇痛药。然后，我们将通过3-评估MAPA对CMP结果的效率武装RCT：（1）自引导的MAPA，（2）面对面培训 + MAPA和（3）等待名单常规护理控制。两个MAPA小组的参与者将继续接受通常的护理 1个月随访后，对照组将被重新连接到任何一个MAPA组中。与我们的飞行员相比研究，这是在马里兰州和内华达州进行的更大范围和长期的RCT，可确保站点将是包容性的，代表潜水员的人群。我们的长期目标是消除疼痛护理分发，并减少社会对阿片类药物的缓解疼痛。拟议的研究利用技术将有助于Advance Advance Mapa，这是一种新颖，易于发射，快速，安全，和非药理学工具纳入了自我管理计划，以安全地管理现实世界中的痛苦设置。