College of Nursing, Washington State University, Spokane, WA, USA; Program of Excellence in Addictions Research, Washington State University, Spokane, WA, USA.
College of Nursing, Washington State University, Spokane, WA, USA; Program of Excellence in Addictions Research, Washington State University, Spokane, WA, USA.
Addict Behav. 2018 Nov;86:130-137. doi: 10.1016/j.addbeh.2018.04.019. Epub 2018 Apr 27.
Persistent pain has been recognized as an important motivator that can lead individuals to misuse opioids. New approaches are needed to test pain treatments that can improve outcomes for people with persistent pain in medication-assisted behavioral treatment for opioid use disorder. This study piloted an online pain self-management program to explore acceptability and treatment effects.
A sample of 60 adults diagnosed with chronic non-cancer pain and receiving medication-assisted behavioral treatment at one of two clinics were randomized into either treatment group with access to an online pain management program or waitlist attention control. Participants received online surveys via email at baseline and post-treatment at week 8.
The majority of participants (n = 44; 73%) reported that their first use of opioids was in response to a painful event. Those who engaged in the online program had significantly lower pain interference, pain severity, opioid misuse measures, and depressive symptoms after eight weeks while pain self-efficacy was increased.
Our results suggest the online pain self-management program content may be helpful for managing physical and emotional symptoms experienced by individuals with co-occurring pain and opioid use disorders. To improve online engagement, more support is necessary to assist with technology access and completion of online activities.
持续性疼痛已被认为是导致个体滥用阿片类药物的一个重要动机。在药物辅助行为治疗阿片类药物使用障碍中，需要新的方法来测试可以改善持续性疼痛患者治疗效果的疼痛治疗方法。本研究初步尝试了一种在线疼痛自我管理方案，以探索其可接受性和治疗效果。
本研究选取了 60 名在两家诊所接受药物辅助行为治疗的慢性非癌性疼痛患者作为研究对象，将他们随机分为治疗组和等待名单对照组。治疗组可访问在线疼痛管理程序，对照组仅接受常规治疗。参与者在基线和治疗后 8 周通过电子邮件接收在线调查。
大多数参与者（n=44；73%）报告称，他们首次使用阿片类药物是为了应对疼痛事件。八周后，接受在线方案的参与者疼痛干扰、疼痛严重程度、阿片类药物滥用指标和抑郁症状显著降低，而疼痛自我效能感增加。
我们的结果表明，在线疼痛自我管理方案的内容可能有助于管理同时患有疼痛和阿片类药物使用障碍的个体的身体和情绪症状。为了提高在线参与度，需要更多的支持来帮助患者获得技术支持并完成在线活动。
