Internet-Based Video-Conferencing to Address Alcohol Use and Pain Among Heavy Drinkers in HIV-Care

基于互联网的视频会议解决艾滋病毒护理中重度饮酒者的饮酒和疼痛问题

• 批准号: 10019311
• 负责人: TIBOR P. PALFAI
• 金额: $ 43.09万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10019311
• 关键词: Address; Adherence; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcoholic beverage heavy drinker; Alcohols; Anxiety; Behavior; Behavior Therapy; Behavioral; Behavioral Mechanisms; Biological; Caring; Client satisfaction; Consultations; Data; Dropout; Drug usage; Evaluation; Face; Feedback; Goals; HIV; HIV Infections; HIV risk; Heavy Drinking; Internet; Intervention; Interview; Link; Mediator of activation protein; Medical; Morbidity - disease rate; Motivation; Outcome; Pain; Pain management; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacology; Phase; Population; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Risk; Risk-Taking; Sampling; Secondary pain; Self Efficacy; Severities; Symptoms; Testing; Time; Treatment Efficacy; Videoconferencing; alcohol intervention; alcohol related consequences; alcohol response; base; chronic pain; chronic pain patient; comorbidity; comparison intervention; daily functioning; depressive symptoms; efficacy testing; evidence base; experience; high risk drinking; illicit drug use; improved; indexing; mortality; novel; pain outcome; pain patient; pain reduction; pain self-management; phosphatidylethanol; pilot trial; primary outcome; programs; psychosocial; telehealth; therapy development; treatment adherence

PROJECT SUMMARY/ABSTRACT Chronic pain and heavy drinking are common co-occurring conditions among people living with HIV infection (PLWH) each of which have a negative impact on daily functioning and HIV-related outcomes. Moreover, these comorbid conditions have a significant impact on one another. Pain is an important trigger for alcohol use among heavy drinkers and is linked with the experience of negative alcohol-related consequences. Among PLWH, moderate or greater pain has been linked with risky drinking over time. Similarly, problem drinking interferes with pain management efforts among those with chronic pain and is linked to earlier dropout from treatment. Clinicians face a number of challenges in their efforts to address these frequently co-occurring conditions including low patient motivation for change, poor adherence to treatment, and frequent barriers to using pharmacological treatments to adequately treat both conditions. Given the rates of chronic pain and heavy drinking among PLWH, their combined impact on daily functioning and HIV-outcomes, and available treatment limitations, there would be considerable benefit to an integrative behavioral approach to address these comorbid conditions in a manner that may be readily incorporated into HIV-care settings and easily utilized by patients. Through the UH2/UH3 mechanism the objectives of the proposal are to, 1) develop an integrated behavioral video telehealth intervention approach to reduce pain and alcohol use among heavy drinking HIV-infected patients with chronic pain and determine its feasibility and acceptability (UH2) and 2) obtain effect size estimates of intervention efficacy through a randomized controlled pilot trial (UH3). This study represents a first effort to utilize a video telehealth approach to address alcohol use and pain for patients this setting. The UH2 component will be used for treatment development and initial testing with a small sample of patients in an open pilot. Evidence of patient acceptability and feasibility in this setting along with pre-post changes in identified outcomes will provide data on which to base the UH3 component which will be a preliminary test of intervention efficacy through a randomized controlled pilot trial.

项目概要/摘要 慢性疼痛和酗酒是艾滋病毒感染者常见的并发病症 (PLWH) 其中每一个都会对日常功能和艾滋病毒相关结果产生负面影响。而且， 这些合并症相互之间有重大影响。疼痛是酒精的重要触发因素 在重度饮酒者中使用，并且与酒精相关的负面后果的经历有关。 在感染者中，随着时间的推移，中度或重度疼痛与危险饮酒有关。同样，问题 饮酒会干扰慢性疼痛患者的疼痛管理工作，并与早期辍学有关 来自治疗。临床医生在努力解决这些经常同时发生的问题时面临着许多挑战 包括患者改变的动力低、治疗依从性差以及经常遇到障碍 使用药物治疗来充分治疗这两种情况。鉴于慢性疼痛的发生率和 艾滋病病毒感染者中的大量饮酒及其对日常功能和艾滋病毒结果的综合影响，以及可利用的 治疗的局限性，采用综合行为方法来解决问题将有相当大的好处 这些共病的方式可以很容易地纳入艾滋病毒护理环境中，并且很容易 被患者利用。通过 UH2/UH3 机制，该提案的目标是：1) 制定 综合行为视频远程医疗干预方法可减少重型患者的疼痛和饮酒 患有慢性疼痛的HIV感染者饮酒并确定其可行性和可接受性（UH2）和2） 通过随机对照试验（UH3）获得干预效果的效应大小估计。这 研究代表了利用视频远程医疗方法来解决患者饮酒和疼痛问题的首次尝试 这个设置。 UH2 组件将用于治疗开发和小样本初步测试 开放试点中的患者数量。患者在这种情况下的可接受性和可行性的证据以及事前事后 已确定结果的变化将为 UH3 组成部分提供数据，该组成部分将成为 通过随机对照试点试验初步检验干预效果。