Development of a Behavioral Intervention for Chronic Pain in Individuals with HIV

开发针对艾滋病毒感染者慢性疼痛的行为干预措施

• 批准号: 9180066
• 负责人: Jessica S Merlin
• 金额: $ 19.35万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-15 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9180066
• 关键词: Address; Affect; Alcohol or Other Drugs use; Anti-Retroviral Agents; Anxiety; Area; Award; Behavior Therapy; Behavioral Research; Biological; California; Caring; Chronic; Chronic Disease; Clinic; Clinical; Clinical Trials; Cognitive Therapy; Collaborations; Comorbidity; Complex; Consensus; Data; Development; Doctor of Philosophy; Emotional; Functional disorder; Funding; Goals; HIV; Health; Health Psychology; Impairment; Individual; Institute of Medicine (U.S.); Intervention; Intervention Trial; Investigation; K-Series Research Career Programs; Manuals; Medical; Medicine; Mental Depression; Mental Health; Mental disorders; Mentors; Mentorship; Mood Disorders; Neurobiology; Neurofibromin 2; Neurology; Opioid; Outcome; Pain; Pain Research; Pain management; Participant; Patients; Pharmacology; Physical Function; Population; Positioning Attribute; Prevalence; Process; Provider; Psychology; Public Health; Randomized Controlled Trials; Recruitment Activity; Research; Research Personnel; Risk; San Francisco; Self Management; Series; Site; Social Environment; System; Target Populations; Testing; Time; Training; Universities; Work; addiction; arm; associated symptom; base; behavior test; behavioral clinical trial; biopsychosocial; career; career development; chronic pain; cohort; evidence base; experience; functional disability; improved; pilot trial; prescription opioid; professor; prospective; psychologic; psychosocial; public health relevance; social cognitive theory; success; theories; therapy development

 DESCRIPTION (provided by applicant): The overall goal of this 4-year K23 proposal is to support Jessica Merlin, MD, MBA to become an independent investigator in the field of HIV and chronic pain, with a focus on health psychology/mental health and chronic pain behavioral intervention development and testing. Chronic pain is a chronic condition with a unique neurobiologic basis, which has a substantial impact on physical and emotional function. Chronic pain in HIV-infected patients is common, and associated with serious health consequences, including up to 10 times greater odds of impaired physical function. Many pharmacologic therapies, including opioids, often do not lead to improved pain and function, and carry significant risk. Evidence-based behavioral interventions are among the most effective and safe non-pharmacologic chronic pain treatments investigated in the general medical population. Therefore, behavioral interventions to improve pain, physical, and emotional function in HIV-infected patients are needed. There is much to be learned from existing interventions. However, the success of a behavioral intervention is heavily influenced by how well it is tailored to the target population's biological, psychological, and social environment. Therefore, the Specific Aims of this proposal are: Aim 1: Use intervention mapping to systematically develop and pre-test a tailored behavioral intervention for chronic pain in HIV-infected patients. Aim 2: Conduct a two-arm pilot randomized controlled trial of the behavioral intervention compared to routine HIV and pain care, to determine feasibility, acceptability, and preliminary impact. Based on preliminary studies, our proposed intervention targets include depression/anxiety, substance use, and use of prescription opioids for pain management; new targets may emerge during the intervention mapping process. The proposed research represents the first study to address chronic pain as a chronic disease in HIV-infected patients, and to develop and test a behavioral intervention specifically tailored to this population. At the completion of the pilot trial in Aim , the intervention will be ready to be tested in an R01 to evaluate its efficacy. This proposal represents a 4-year comprehensive mentoring, training, and research plan to transition the candidate, Dr. Merlin, to a career as a successful independent investigator. By the end of the award period, Dr. Merlin will have contributed substantially to the field of HIV and chronic pain behavioral research. Already an expert on biomedical approaches to chronic pain in HIV-infected individuals, she will be positioned to become a leader in developing and testing behavioral interventions in this area, including conducting behavioral clinical trials.

 描述（由申请人提供）：这项为期 4 年的 K23 提案的总体目标是支持医学博士、工商管理硕士 Jessica Merlin 成为 HIV 和慢性疼痛领域的独立研究者，重点关注健康心理学/心理健康和慢性疼痛行为干预的开发和测试。慢性疼痛是一种具有独特神经生物学基础的慢性疾病，对身体和情绪功能有重大影响。 HIV 感染者的慢性疼痛很常见，并且会带来严重的健康后果，包括身体功能受损的几率增加 10 倍。许多药物疗法，包括阿片类药物，通常不会改善疼痛和功能，并且具有很大的风险。基于证据的行为干预是在普通医学人群中研究的最有效和最安全的非药物慢性疼痛治疗方法之一。因此，需要通过行为干预来改善艾滋病毒感染者的疼痛、身体和情感功能。从现有的干预措施中可以学到很多东西。然而，行为干预的成功很大程度上取决于它是否适合目标人群的生物、心理和社会环境。因此，该提案的具体目标是： 目标 1：利用干预图系统地开发和预先测试针对 HIV 感染者慢性疼痛的定制行为干预措施。目标 2：开展 将行为干预与常规艾滋病毒和疼痛护理进行比较的双臂试点随机对照试验，以确定可行性、可接受性和初步影响。根据初步研究，我们提出的干预目标包括抑郁/焦虑、物质使用以及使用处方阿片类药物来控制疼痛；在干预规划过程中可能会出现新的目标。拟议的研究代表了第一项将慢性疼痛作为艾滋病毒感染者慢性疾病的研究，并开发和测试专门针对该人群的行为干预措施。 Aim 的试点试验完成后，该干预措施将准备在 R01 中进行测试，以评估其功效。该提案代表了一项为期 4 年的全面指导、培训和研究计划，旨在将候选人 Merlin 博士转变为一名成功的独立研究者。到奖励期结束时，梅林博士将为艾滋病毒和慢性疼痛行为研究领域做出重大贡献。她已经是艾滋病毒感染者慢性疼痛生物医学方法方面的专家，她将成为开发和测试该领域行为干预措施的领导者，包括进行行为临床试验。