Development of a Personalized Feedback Intervention Targeting Pain-Related Anxiety for Hazardous Drinkers with Chronic Pain

针对患有慢性疼痛的危险饮酒者的疼痛相关焦虑开发个性化反馈干预措施

• 批准号: 10641062
• 负责人: Andrew H. Rogers
• 金额: $ 0.19万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2024-03-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10641062
• 关键词: Absence of pain sensation; Address; Affective; Alcohol abuse; Alcohol consumption; Alcohols; Anxiety; Basic Science; Behavior; Behavior Therapy; Caring; Chronic; Clinical Trials Design; Computers; Coping Behavior; Data; Development; Expectancy; Feedback; Focus Groups; Frequencies; General Population; Guidelines; Health; Individual; Intention; Intervention; Knowledge; Lead; Mediating; Mediator of activation protein; Medical; Mental Health; Methods; Modeling; Motivation; Opioid; Outcome; Pain; Pain management; Participant; Phase; Planning Theory; Population; Protocols documentation; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Risk; Sampling; Standardization; Testing; Translating; Underserved Population; United States National Institutes of Health; Work; acceptability and feasibility; alcohol behavior; alcohol expectancy; base; behavior change; brief intervention; chronic pain; comorbidity; coping; disability; drinking; effective intervention; efficacy evaluation; follow up assessment; follow-up; hazardous drinking; health care settings; high risk; innovation; novel; pain reduction; physical conditioning; pilot test; premature; primary outcome; prospective; public health priorities; secondary outcome; sex; social; therapy design; therapy development

Project Summary/Abstract Hazardous alcohol use contributes to mental and physical health problems, disability, and may lead to increased risk of premature death3,4. Among individuals with chronic pain the rate of hazardous alcohol use is elevated compared to the general population5, yet, hazardous alcohol users with chronic pain remain an underserved group. There is a critical need to test alternative and complimentary approaches to the implementation of effective interventions to reduce hazardous alcohol use among this high-risk segment of the general population; doing so in an integrated fashion (i.e., jointly targeting alcohol and affective mechanisms that may maintain pain-alcohol associations) may provide a more efficient and targeted intervention approach. Targeting pain-related anxiety, a transdiagnostic vulnerability factor that is prospectively associated with both hazardous drinking and chronic pain6,7, may be beneficial. Thus, more work is needed to evaluate the benefit of targeting elevated pain-related anxiety among hazardous drinkers with chronic pain. Our approach will follow a staged model consistent with NIH guidelines for developing and standardizing behavioral interventions. Phase IA activities will involve collecting qualitative feedback from iterative focus groups (N = 10) to refine intervention content and evaluate treatment acceptability and feasibility. Phase IB activities will include a proof-of-concept and highly rigorous randomized clinical trial designed to compare pain-related anxiety/alcohol PFI (PA-PFI) to control PFI (C-PFI) among a sample of 130 hazardous drinkers with chronic pain who have elevated levels of pain-related anxiety. This study represents an important and pivotal step in the larger landscape of translating basic research to more efficacious strategies for reducing hazardous drinking among underserved populations with medical comorbidities. The proposed intervention would be highly disseminable and relevant to millions of hazardous drinkers with chronic pain. Given the collective public health impact of chronic pain and hazardous drinking, the proposed study will yield findings that enhance scientific knowledge, enhance our understanding of mechanisms in reciprocal pain-alcohol relations, and inform the development of novel treatments for hazardous drinkers with chronic pain with elevated pain-related anxiety that are adaptable and easily implemented across a variety of healthcare settings.

项目概要/摘要 有害饮酒会导致精神和身体健康问题、残疾，并可能导致 过早死亡的风险增加3,4。在患有慢性疼痛的个体中，有害酒精使用率是 与一般人群相比5，然而，患有慢性疼痛的有害酒精使用者仍然是一个 服务不足的群体。迫切需要测试替代和补充方法 实施有效的干预措施，减少这一高风险人群的有害酒精使用 一般人群；以综合方式做到这一点（即共同针对酒精和情感机制 可能会维持疼痛与酒精的关联）可能会提供更有效、更有针对性的干预方法。 针对与疼痛相关的焦虑，这是一种跨诊断的脆弱性因素，预计与两者相关 危险饮酒和慢性疼痛6,7可能是有益的。因此，需要做更多的工作来评估 针对患有慢性疼痛的危险饮酒者中与疼痛相关的焦虑升高的好处。我们的 方法将遵循与 NIH 指导方针一致的分阶段模型，用于开发和标准化行为 干预措施。 IA 阶段活动将涉及从迭代焦点小组收集定性反馈（N = 10） 细化干预内容并评估治疗的可接受性和可行性。 IB 阶段活动将包括 一项概念验证和高度严格的随机临床试验，旨在比较疼痛相关的 焦虑/酒精 PFI (PA-PFI) 控制 PFI (C-PFI)，其中包括 130 名患有慢性疾病的危险饮酒者样本 与疼痛相关的焦虑水平升高的人。这项研究代表了重要且关键的一步 将基础研究转化为更有效的减少危险的策略的更大前景 患有合并症的服务不足的人群中饮酒。拟议的干预措施是 具有高度传播性，并与数百万患有慢性疼痛的危险饮酒者相关。鉴于集体公众 慢性疼痛和危险饮酒对健康的影响，拟议的研究将得出以下结果： 科学知识，增强我们对疼痛与酒精相互关系机制的理解，以及 为患有慢性疼痛且疼痛相关性升高的危险饮酒者开发新疗法提供信息 焦虑症具有适应性，并且可以在各种医疗保健环境中轻松实施。