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综合远程医疗干预以减少 HIV 感染者的慢性疼痛和不健康饮酒:一项随机对照试验方案。

Integrated telehealth intervention to reduce chronic pain and unhealthy drinking among people living with HIV: protocol for a randomized controlled trial.

机构信息

Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA.

Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.

出版信息

Addict Sci Clin Pract. 2024 Sep 5;19(1):64. doi: 10.1186/s13722-024-00493-3.

Abstract

BACKGROUND

Unhealthy alcohol use represents a significant risk for morbidity and mortality among people living with HIV (PLWH), in part through its impact on HIV management. Chronic pain, a common comorbidity, exacerbates suboptimal engagement in the HIV care continuum and has reciprocal detrimental effects on alcohol outcomes. There are no integrated, accessible approaches that address these comorbid conditions among PLWH to date. This paper describes a research study protocol of an integrated telehealth intervention to reduce unhealthy drinking and chronic pain among PLWH (Motivational and Cognitive-Behavioral Management for Alcohol and Pain [INTV]).

METHODS

Two-hundred and fifty PLWH with unhealthy drinking and chronic pain will be recruited nationally via online advertisement. Informed consent and baseline assessments occur remotely, followed by 15 days of ecological momentary assessment to assess alcohol use, chronic pain, functioning, and mechanisms of behavior change. Next, participants will be randomized to either the INTV or Control (CTL) condition. Individuals in both conditions will meet with a health counselor through videoconferencing following randomization, and those in the INTV condition will receive 6 additional sessions. At 3- and 6-months post-baseline, participants will complete outcome assessments. It is hypothesized that the INTV condition will result in reduced unhealthy alcohol use and pain ratings compared to the CTL condition.

CONCLUSION

This protocol paper describes a randomized controlled trial which tests the efficacy of a novel, integrated telehealth approach to reduce unhealthy alcohol use and chronic pain for PLWH, two common comorbid conditions that influence the HIV treatment cascade.

GOV IDENTIFIER

NCT05503173.

摘要

背景

不健康的饮酒行为是 HIV 感染者(PLWH)发病和死亡的一个重要风险因素,部分原因是其对 HIV 管理的影响。慢性疼痛是一种常见的合并症,会加剧 PLWH 对 HIV 护理连续体的参与不足,并对酒精结果产生不利的影响。迄今为止,还没有针对这些合并症的综合、可及的方法。本文介绍了一项综合远程医疗干预研究的方案,以减少 PLWH 的不健康饮酒和慢性疼痛(动机和认知行为管理酒精和疼痛[INTV])。

方法

将通过在线广告在全国范围内招募 250 名有不健康饮酒和慢性疼痛的 PLWH。远程知情同意和基线评估后,进行 15 天的生态瞬时评估,以评估酒精使用、慢性疼痛、功能和行为改变的机制。然后,参与者将被随机分配到 INTV 或对照组(CTL)条件。随机分组后,两组的参与者都将通过视频会议与健康顾问会面,而 INTV 组的参与者将再接受 6 次额外的治疗。在基线后 3 个月和 6 个月,参与者将完成结果评估。假设 INTV 条件与 CTL 条件相比,将导致不健康的饮酒减少和疼痛评分降低。

结论

本文描述了一项随机对照试验,该试验测试了一种新的综合远程医疗方法对减少 PLWH 常见合并症(影响 HIV 治疗连续体的两个因素)即不健康饮酒和慢性疼痛的疗效。

政府标识符

NCT05503173。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d7/11375999/1a6af35d513a/13722_2024_493_Fig1_HTML.jpg

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