Integrated behavioral program for prescription opiate addiction and chronic pain

针对处方阿片成瘾和慢性疼痛的综合行为计划

• 批准号: 8454664
• 负责人: KENNETH W THOMPSON
• 金额: $ 5.59万
• 依托单位: CARON FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8454664
• 关键词: Addictive Behavior; Address; Affect; Aftercare; Alcohol or Other Drugs use; Anxiety; Attention; Behavior Therapy; Behavioral; Client satisfaction; Cognitive Therapy; Data; Development; Distress; Drug usage; Economics; Effectiveness of Interventions; Employment; Evaluation; Evidence based treatment; Exercise; Foundations; Future; HIV; Healthcare; Individual; Intervention; Mediating; Mediation; Mediator of activation protein; Medical; Medication Management; Mental Depression; Mental Health; Modeling; Opiate Addiction; Opiates; Opioid; Opioid Analgesics; Outcome; Outcome Measure; Pain; Pain Disorder; Pain management; Patients; Pennsylvania; Perception; Personal Satisfaction; Pharmaceutical Preparations; Physical therapy; Policy Maker; Population; Principal Investigator; Productivity; Public Health; Publishing; Quality of life; Randomized; Recruitment Activity; Relapse; Relative (related person); Reporting; Resources; Risk Behaviors; Rural; Science; Support Groups; Symptoms; Testing; Therapeutic Effect; Third-Party Payer; Treatment Cost; Treatment Protocols; Treatment outcome; Work; addiction; base; biopsychosocial; chronic pain; cost; cost effective; cost effectiveness; design; economic cost; effective therapy; evidence base; follow-up; high risk behavior; improved; interest; prescription opiate; primary outcome; programs; prospective; psychologic; psychosocial; social; standard care; treatment as usual; treatment program

DESCRIPTION (provided by applicant): Project Summary: We propose to integrate a chronic pain management program based on cognitive behavioral therapy plus physical therapy (CBT+PT) with addiction treatment and test this package with a population of chronic pain patients addicted to opioid analgesic medications (CPP+OD) who are in residential addiction treatment at the Caron Foundation. The study employs a prospective two-group randomized design, in which subjects will be randomly assigned to receive one of two conditions: Treatment-as-usual (TAU) at Caron plus the integrated CBT-PT program (i.e., CBT-PT), or TAU plus an attention control support group. The baseline assessment will be administered during the first week of treatment, and data on potential mediators and pain levels will be obtained during treatment at weeks 2 and 4. The follow-up will be at 3 months post-discharge, and will provide post-treatment data on substance use, pain, and psychosocial functioning. Approximately 120 subjects will be recruited into the study during a 28- month period. The primary outcome measures will be post-treatment drug use, within- and post-treatment pain levels and mobility, and post-treatment psychosocial functioning. In addition, the study will evaluate the cost-effectiveness of the intervention. This is critical information for treatment programs, policy makers, and third-party payers who may be interested in implementing the intervention. Additional secondary analyses will examine potential mediator effects of changes in depression, anxiety, and acceptance of pain, substance use and pain outcomes. Relevance: The development of an integrated program to address chronic pain, opioid dependence, and psychiatric distress could have substantial benefit to science and to public health. Patients who have co-occurring pain and addictive disorders may have a high vulnerability to relapse to addictive behaviors if their pain is not managed. The results of this study will provide critical treatment and economic information for treatment programs, policy makers, and third-party payers who may be interested in implementing the intervention. This initial test of an evidence-based behavioral intervention for chronic pain will become the basis for future work at Caron to further develop and improve effective approaches to pain management which will have economic benefits to patients and treatment programs that outweigh additional costs.

描述（由申请人提供）：项目摘要：我们建议将基于认知行为疗法加物理疗法（CBT+PT）的慢性疼痛管理计划与成瘾治疗进行结合，并与成瘾的慢性疼痛患者（CPP+OD）中的慢性疼痛患者进行测试，这些患者是Caron基础的居住成瘾治疗。该研究采用了前瞻性的两组随机设计，其中将随机分配受试者接受两种条件之一：Caron的治疗方式（TAU）加上综合CBT-PT计划（即CBT-PT）或TAU以及注意力控制支持组。基线评估将在治疗的第一周内进行，并且在第2周和第4周的治疗期间将获得有关潜在介质和疼痛水平的数据。随访后将在入院后3个月，并提供有关药物使用，疼痛，疼痛和心理社会功能的治疗后数据。在28个月内，将大约将大约120名受试者招募到研究中。主要结果指标将是治疗后药物使用，治疗后和治疗后疼痛水平和活动能力以及治疗后的社会心理功能。此外，该研究将评估干预措施的成本效益。这是可能有兴趣实施干预措施的治疗计划，政策制定者和第三方付款人的关键信息。其他二次分析将检查抑郁，焦虑，疼痛，药物使用和疼痛结果的变化的潜在介体影响。相关性：制定解决慢性疼痛，阿片类药物依赖和精神病困扰的综合计划可能会对科学和公共卫生带来可观的好处。如果无法治疗疼痛，患有同时发生疼痛和上瘾疾病的患者可能会有很大的脆弱性复发到上瘾的行为。这项研究的结果将为可能有兴趣实施干预措施感兴趣的治疗计划，决策者和第三方付款人提供关键的治疗和经济信息。对基于证据的慢性疼痛行为干预措施的初步测试将成为卡伦将来在进一步开发和改善有效疼痛管理方法的基础，这将对患者和治疗计划具有超过额外费用的经济利益。