Developing a novel treatment for patients with chronic pain and Opioid User Disorder.
Developing a novel treatment for patients with chronic pain and Opioid User Disorder.
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DOI：
10.1186/s13011-022-00464-4
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发表时间：
2022-05-07
影响因子：
3.3
通讯作者：
Epstein, Elizabeth
中科院分区：
文献类型：
--
作者：
Wachholtz, Amy;Robinson, Dallas;Epstein, Elizabeth
开发基于经验的、社区治疗友好的心理治疗干预措施以改善慢性疼痛和阿片类药物使用障碍共病患者的治疗至关重要。了解增加患者依从性和出勤率的因素是很重要的，沿着有针对性地解决这些问题的策略。基于对OUD和慢性疼痛成年人的初步心理生理学研究，我们创建了一种综合认知行为，为期12周的门诊小组治疗，称为STOP（阿片类药物成瘾和疼痛的自我调节治疗）。在这项研究中，我们在第1a阶段的可行性和可接受性研究中对STOP进行了试点测试，以确定独特的治疗需求和因素，从而增加了会议出席率，坚持治疗并改善了结果。14名接受OUD药物治疗并伴有慢性疼痛的患者参加了研究。STOP的出勤率很高（80%;患者积极参与）。尿液毒理学显示第8周后未使用违禁药物。从干预前到3个月随访的数据分析显示功能显著改善（F（1，12）= 45.82;p < 0.001），疼痛严重程度降低（F（1，12）= 37.62;p < 0.01）。参与者报告了在疼痛发作或渴望期间抵消生理激活的独特工具的赞赏。与会者还报告受益于会议中的视觉教具，适用的疼痛心理学信息，带回家的工具，放松练习的工具，学习应用治疗工具。STOP是一种90分钟12周的滚动进入小组治疗，基于先前的研究，确定了疼痛和OUD患者的心理生理需求，可以无缝地纳入社区成瘾治疗诊所。STOP的初步结果是有希望的，患者参与度和依从性高，药物使用和疼痛显著减少。ClinicalTrials.Gov NCT 03363243，于2017年12月6日注册。
It is critical to develop empirically based, community-treatment friendly, psychotherapy interventions to improve treatment for patients with comorbid chronic pain and Opioid Use Disorder. Understanding factors that increase patient adherence and attendance is important, along with strategies targeted to address those issues. Based on initial psychophysiology research on adults with OUD and chronic pain, we created an integrated cognitive-behavioral, 12-week outpatient group therapy called STOP (Self-regulation Therapy for Opioid addiction and Pain). In this study, we pilot tested STOP in a Stage 1a feasibility and acceptability study to identify unique treatment needs and factors that increased session attendance, adherence to treatment, and improved outcomes. Fourteen individuals on medication for OUD with co-occurring chronic pain participated. STOP had high attendance rates (80%; and active patient engagement). Urine toxicology showed no illicit drug use after week 8. Data analysis from pre-intervention to a 3-month follow-up showed significant functional improvement (F(1,12) = 45.82;p < 0.001) and decreased pain severity levels (F(1,12) = 37.62;p < 0.01). Participants reported appreciation of the unique tools to counteract physiological activation during a pain flare or craving. Participants also reported benefit from in-session visual aids, applicable pain psychology information, take-home worksheets, tools for relaxation practice, learning to apply the therapy tools. STOP is a 90-min 12-week rolling-entry group therapy based on previous research identifying psychophysiological needs of pain and OUD patients that can be seamlessly incorporated into community addiction treatment clinics. Preliminary results of STOP are promising with high patient engagement and adherence and significant reductions in drug use and pain. ClinicalTrials.Gov NCT03363243, Registered Dec 6, 2017.
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DOI：
10.3109/00952990.2011.596970
发表时间：
2011-09
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
Donovan DM;Daley DC;Brigham GS;Hodgkins CC;Perl HI;Floyd AS
通讯作者：
Floyd AS
影响因子：
--
作者：
Hser, YI;Hoffman, V;Anglin, MD
通讯作者：
Anglin, MD
影响因子：
6
作者：
Larson, Mary Jo;Paasche-Orlow, Michael;Samet, Jeffrey H.
通讯作者：
Samet, Jeffrey H.
影响因子：
4.2
作者：
Barry, Declan T.;Beitel, Mark;Schottenfeld, Richard S.
通讯作者：
Schottenfeld, Richard S.
影响因子：
4
作者：
Currie, SR;Hodgins, DC;Armstrong, S
通讯作者：
Armstrong, S