Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, Boston, MA 02215, USA.
Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, 801 Massachusetts Ave, 2nd Floor, Boston, MA 02118, USA.
Drug Alcohol Depend. 2024 Mar 1;256:111121. doi: 10.1016/j.drugalcdep.2024.111121. Epub 2024 Feb 10.
Hazardous drinking has been associated with chronic pain in community and medical samples. The purpose of this study was to develop a novel, integrated mobile health intervention that improves pain management and reduces hazardous drinking that may be implemented in primary care settings.
Forty-eight participants with moderate or greater chronic pain and hazardous drinking were recruited from primary care clinics and through social media sites. Following baseline assessment, participants were randomized to a counselor-supported smartphone app intervention (INTV) or a counselor delivered treatment-as-usual control condition (CTL).
Results supported the feasibility and acceptability of the smartphone app intervention. Participants found it easy to use, reported high levels of satisfaction, and showed high levels of engagement with the app. Between-group effect size estimates at follow-up showed small effects for the intervention on pain ratings. However, using clinically meaningful change thresholds of 30% and 50% improvement in pain scores, 38% and 25% respectively of those in the INTV condition showed reductions compared to 20% and 12.5% respectively in the CTL condition. Effect size estimates did not indicate intervention superiority on alcohol outcomes as participants in both conditions showed considerable reductions in drinking over the course of the study.
Results supported the view that a mobile health intervention delivered via smartphone with electronic coaching is a feasible and acceptable method of addressing chronic pain among those who engage in hazardous drinking. Future work should test the efficacy of this approach in a fully powered trial.
在社区和医疗样本中,危险饮酒与慢性疼痛有关。本研究的目的是开发一种新的、综合的移动健康干预措施,以改善疼痛管理并减少危险饮酒,该措施可能在初级保健环境中实施。
从初级保健诊所和社交媒体网站招募了 48 名有中度或以上慢性疼痛和危险饮酒的参与者。在基线评估后,参与者被随机分配到顾问支持的智能手机应用程序干预组(INTV)或顾问提供的常规治疗对照组(CTL)。
研究结果支持智能手机应用程序干预的可行性和可接受性。参与者发现它使用起来很容易,报告了很高的满意度,并表现出了对应用程序的高度参与度。随访时的组间效应大小估计显示,干预对疼痛评分的影响较小。然而,使用疼痛评分提高 30%和 50%的临床有意义的变化阈值,分别有 38%和 25%的 INTV 组的参与者与分别有 20%和 12.5%的 CTL 组的参与者相比,疼痛评分有所降低。由于在研究过程中两组参与者的饮酒量都有明显减少,因此干预对酒精结果的效果估计并没有表明干预的优越性。
研究结果支持这样一种观点,即通过智能手机提供带有电子指导的移动健康干预措施是一种可行且可接受的方法,可以解决危险饮酒者的慢性疼痛问题。未来的工作应该在一个充分有力的试验中测试这种方法的疗效。