Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial.
Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial.
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DOI：
10.1037/a0035798
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发表时间：
2014-06
影响因子：
5.9
通讯作者：
Howard MO
中科院分区：
文献类型：
--
作者：
Garland EL;Manusov EG;Froeliger B;Kelly A;Williams JM;Howard MO
阿片类药物疗法现在是慢性疼痛的主要治疗方法，这一问题影响了近三分之一的美国人口。鉴于处方阿片类药物滥用和阿片类药物相关死亡率的急剧上升，需要采取新的行为干预措施。本研究的目的是进行正念导向恢复增强（MORE）的早期随机对照试验，MORE是一种多模式干预，旨在同时靶向慢性疼痛和阿片类药物滥用的基础机制。慢性疼痛患者（N=115;平均年龄= 48±14; 68%为女性）被随机分配至为期8周的MORE或支持组（SG）。在治疗前和治疗后以及3个月随访时测量结果。简明疼痛量表评估疼痛严重程度和干扰的变化。阿片类药物使用障碍状态的变化通过当前阿片类药物滥用测量来测量。对阿片类药物的需求，压力，无反应性，疼痛感觉的重新解释和重新评价也进行了评估。与SG参与者相比，更多参与者报告疼痛严重程度（p = .038）和干扰（p = .003）显著降低，这在3个月随访时得以维持，并通过增加无反应性和重新解释疼痛感觉来介导。与SG参与者相比，MORE的参与者表现出显著更少的压力觉醒（p = .034）和对阿片类药物的渴望（p = .027），并且在治疗后立即不再符合阿片类药物使用障碍的标准（p = .05）;然而，这些影响在随访时并不持续。研究结果表明，MORE作为治疗同时发生的处方阿片类药物滥用和慢性疼痛的初步可行性和有效性。
Opioid pharmacotherapy is now the leading treatment for chronic pain, a problem that affects nearly one-third of the United States population. Given the dramatic rise in prescription opioid misuse and opioid-related mortality, novel behavioral interventions are needed. The purpose of this study was to conduct an early stage randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), a multimodal intervention designed to simultaneously target mechanisms underpinning chronic pain and opioid misuse. Chronic pain patients (N=115; mean age = 48±14; 68% female) were randomized to 8 weeks of MORE or a Support Group (SG). Outcomes were measured at pre- and post-treatment, and at 3-month follow-up. The Brief Pain Inventory assessed changes in pain severity and interference. Changes in opioid use disorder status were measured by the Current Opioid Misuse Measure. Desire for opioids, stress, nonreactivity, reinterpretation of pain sensations, and reappraisal were also evaluated. MORE participants reported significantly greater reductions in pain severity (p = .038) and interference (p = .003) than SG participants, which were maintained by 3-month follow-up and mediated by increased nonreactivity and reinterpretation of pain sensations. Compared with SG participants, participants in MORE evidenced significantly less stress arousal (p = .034) and desire for opioids (p = .027), and were significantly more likely to no longer meet criteria for opioid use disorder immediately following treatment (p = .05); however, these effects were not sustained at follow-up. Findings demonstrate preliminary feasibility and efficacy of MORE as a treatment for co-occurring prescription opioid misuse and chronic pain.
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DOI：
10.3758/bf03203630
发表时间：
1996-02-01
期刊：
BEHAVIOR RESEARCH METHODS INSTRUMENTS & COMPUTERS
影响因子：
--
作者：
Erdfelder, E;Faul, F;Buchner, A
通讯作者：
Buchner, A
DOI：
10.1016/j.jpain.2008.10.008
发表时间：
2009-02
期刊：
The journal of pain
影响因子：
--
作者：
Chou R;Fanciullo GJ;Fine PG;Adler JA;Ballantyne JC;Davies P;Donovan MI;Fishbain DA;Foley KM;Fudin J;Gilson AM;Kelter A;Mauskop A;O'Connor PG;Passik SD;Pasternak GW;Portenoy RK;Rich BA;Roberts RG;Todd KH;Miaskowski C;American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
通讯作者：
American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
影响因子：
7.4
作者：
Butler, Stephen F.;Budman, Simon H.;Jamison, Robert N.
通讯作者：
Jamison, Robert N.
正念训练减少了女性肠易激综合症的严重程度：一项随机对照试验的结果。
DOI：
10.1038/ajg.2011.184
发表时间：
2011-09
期刊：
The American journal of gastroenterology
影响因子：
--
作者：
Gaylord SA;Palsson OS;Garland EL;Faurot KR;Coble RS;Mann JD;Frey W;Leniek K;Whitehead WE
通讯作者：
Whitehead WE
影响因子：
4.7
作者：
Garland EL;Froeliger B;Howard MO
通讯作者：
Howard MO