一项在处方阿片类药物减量期间支持慢性疼痛患者的数字健康干预措施：一项试点随机对照试验。

A digital health intervention to support patients with chronic pain during prescription opioid tapering: a pilot randomised controlled trial.

作者信息

Gholamrezaei Ali, Magee Michael R, McNeilage Amy G, Dwyer Leah, Sim Alison, Ferreira Manuela L, Darnall Beth D, Brake Timothy, Aggarwal Arun, Craigie Meredith, Hollington Irina, Glare Paul, Ashton-James Claire E

机构信息

Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Pain Management Research Institute, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.

出版信息

medRxiv. 2023 May 11:2023.05.10.23289771. doi: 10.1101/2023.05.10.23289771.

DOI:10.1101/2023.05.10.23289771

PMID:37214982

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10197816/

Abstract

INTRODUCTION

Recent changes in opioid prescribing guidelines have led to an increasing number of patients with chronic pain being recommended to taper. However, opioid tapering can be challenging, and many patients require support.

OBJECTIVES

We evaluated the feasibility, acceptability, and potential efficacy of a co-designed psycho-educational video and SMS text messaging intervention to support patients with chronic pain during prescription opioid tapering.

METHODS

A pilot randomised controlled trial was conducted. In addition to their usual care, participants in the intervention group received a psycho-educational video and 28 days of text messages (two SMS/day). The control group received usual care. The feasibility, acceptability, and potential efficacy of the intervention were evaluated. The primary outcome was opioid tapering self-efficacy. Secondary outcomes were pain intensity and interference, anxiety and depression symptom severity, pain catastrophising, and pain self-efficacy.

RESULTS

Of 28 randomised participants, 26 completed the study (13 in each group). Text message delivery was 99.2% successful. Most participants rated the messages as useful, supportive, encouraging, and engaging, 78.5% would recommend the intervention to others, and 64% desired a longer intervention period. Tapering self-efficacy (Cohen's = 0.74) and pain self-efficacy ( = 0.41) were higher and pain intensity ( = 0.65) and affective interference ( = 0.45) lower in the intervention group at week 4.

CONCLUSIONS

It is feasible, acceptable, and potentially efficacious to support patients with chronic pain during prescription opioid tapering with a psycho-educational video and SMS text messaging intervention. A definitive trial has been initiated to test a 12-week intervention.

摘要

引言

近期阿片类药物处方指南的变化导致越来越多慢性疼痛患者被建议逐渐减少用药量。然而，逐渐减少阿片类药物用量可能具有挑战性，许多患者需要支持。

目的

我们评估了一项共同设计的心理教育视频和短信干预措施在处方阿片类药物逐渐减量期间支持慢性疼痛患者的可行性、可接受性和潜在疗效。

方法

进行了一项试点随机对照试验。除常规护理外，干预组参与者观看了心理教育视频并接收28天的短信（每天两条）。对照组接受常规护理。评估了干预措施的可行性、可接受性和潜在疗效。主要结局是阿片类药物逐渐减量自我效能感。次要结局包括疼痛强度和干扰、焦虑和抑郁症状严重程度、疼痛灾难化以及疼痛自我效能感。

结果

28名随机分组的参与者中，26名完成了研究（每组13名）。短信发送成功率为99.2%。大多数参与者认为这些短信有用、有支持作用、鼓舞人心且引人入胜，78.5%的人会向他人推荐该干预措施，64%的人希望延长干预期。在第4周时，干预组的逐渐减量自我效能感（科恩d值 = 0.74）和疼痛自我效能感（ = 0.41）较高，疼痛强度（ = 0.65）和情感干扰（ = 0.45）较低。