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为服务不足的慢性疼痛和抑郁症患者设计综合医疗小组就诊随机对照试验。

Design of the integrative medical group visits randomized control trial for underserved patients with chronic pain and depression.

作者信息

Gardiner Paula, Lestoquoy Anna Sophia, Gergen-Barnett Katherine, Penti Brian, White Laura F, Saper Robert, Fredman Lisa, Stillman Sarah, Lily Negash N, Adelstein Pamela, Brackup Ivy, Farrell-Riley Christine, Kabbara Karim, Laird Lance, Mitchell Suzanne, Bickmore Timothy, Shamekhi Ameneh, Liebschutz Jane M

机构信息

Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States.

Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States.

出版信息

Contemp Clin Trials. 2017 Mar;54:25-35. doi: 10.1016/j.cct.2016.12.013. Epub 2016 Dec 13.

Abstract

BACKGROUND

Given the public health crisis of opioid overprescribing for pain, there is a need for evidence-based non pharmacological treatment options that effectively reduce pain and depression. We aim to examine the effectiveness of the Integrative Medical Group Visits (IMGV) model in reducing chronic pain and depressive symptoms, as well as increasing pain self-management.

METHODS

This paper details the study design and implementation of an ongoing randomized controlled trial of the IMGV model as compared to primary care visits. The research aims to determine if the IMGV model is effective in achieving: a) a reduction in self-reported pain and depressive symptoms and 2) an improvement in the self-management of pain, through increasing pain self-efficacy and reducing use of self-reported pain medication. We intend to recruit 154 participants to be randomized in our intervention, the IMGV model (n=77) and to usual care (n=77).

CONCLUSIONS

Usual care of chronic pain through pharmacological treatment has mixed evidence of efficacy and may not improve quality of life or functional status. We aim to conduct a randomized controlled trial to evaluate the effectiveness of the IMGV model as compared to usual care in reducing self-reported pain and depressive symptoms as well as increasing pain management skills.

摘要

背景

鉴于阿片类药物过度处方用于疼痛治疗所引发的公共卫生危机,需要有基于证据的非药物治疗方案来有效减轻疼痛和抑郁。我们旨在研究综合医疗小组问诊(IMGV)模式在减轻慢性疼痛和抑郁症状以及增强疼痛自我管理方面的有效性。

方法

本文详细介绍了一项正在进行的随机对照试验的研究设计与实施情况,该试验将IMGV模式与初级保健问诊进行比较。该研究旨在确定IMGV模式是否能有效实现:a)自我报告的疼痛和抑郁症状减轻,以及2)通过提高疼痛自我效能和减少自我报告的止痛药物使用来改善疼痛自我管理。我们计划招募154名参与者,将其随机分为干预组(IMGV模式,n = 77)和常规治疗组(n = 77)。

结论

通过药物治疗慢性疼痛的常规护理,其疗效证据不一,可能无法改善生活质量或功能状态。我们旨在进行一项随机对照试验,以评估与常规护理相比,IMGV模式在减轻自我报告的疼痛和抑郁症状以及增强疼痛管理技能方面的有效性。

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