Pilot Testing A Theory-Driven Self- Management Intervention for Chronic Musculoskeletal Pain

项目总结 尽管有一系列的治疗方法，慢性肌肉骨骼疼痛(Cmp)仍然是主要的健康问题。 问题。它是最常见的慢性疼痛类型，尤其发生在关节和背部，持续时间超过 愈合正常(3~6个月)。2016年，20%的美国成年人报告慢性疼痛，其中8%的人 有限的生命活动。药物疗法是当前美国医学界对慢性疼痛的主要治疗方法 实践，但它导致了目前的阿片类药物危机。 在我们以前的工作和经验教训的基础上，我们打算最大限度地提高《行政程序法》的可用性和可及性。 首先，我们将通过开发一款自主导航的移动/网络APA应用程序来提升我们之前的智能手机应用程序 计算机、平板电脑或智能手机上的(MAPA)版本，允许参与者基于 根据他们的喜好，学习自我管理APA。MAPA将包括缩短的视频(约1分钟)，以促进 微学习和整合生态即时评估，以监控遵守情况并实时捕获 疼痛结局和止痛药的使用。然后，我们将通过3- 武装RCT：(1)自我指导的MAPA，(2)面对面培训+MAPA，以及(3)等待名单通常护理控制。 两个MAPA小组的参与者将继续接受常规护理，而常规护理的参与者 对照组在随访1个月后再随机分为两组。与我们的飞行员相比 研究，这是一项更大规模和更长期的随机对照试验，将在马里兰州和内华达州进行，以确保地点 将是包容和代表不同人群的。 我们的长期目标是消除疼痛护理差距，减少我们社会对阿片类药物管理的依赖 疼痛。利用技术，拟议的研究将有助于推进MAPA，一种新颖、易于启动、快速、安全、 以及包含在自我管理计划中的非药理学工具，用于习惯性地管理现实世界中的疼痛 设置。

PROJECT SUMMARY Despite a range of therapeutic approaches, chronic musculoskeletal pain (CMP) continues to be a major health issue. It is the most common type of chronic pain, occurring particularly in the joints and back, lasting beyond normal healing (3-6 months). In 2016, 20% of American adults reported chronic pain and 8% of them had limited life activities. Pharmacotherapy is the predominant treatment for chronic pain in current US medical practice, but it has led to the current opioid crisis. Building upon our prior work and lessons learned, we intend to maximize the usability and accessibility of APA. First, we will advance our previous smartphone app by developing a self-guided mobile/web-enabled APA app (mAPA) version on a computer, tablet, or smartphone to allow participants to access APA information based on their preferences and learn to self-administer APA. mAPA will include shortened videos (~1 min) to facilitate micro-learning and incorporate ecological momentary assessment to monitor adherence and capture real-time pain outcomes and analgesic use. Then, we will evaluate the efficacy of mAPA on CMP outcomes through a 3- armed RCT: (1) Self-guided mAPA, (2) In-Person Training + mAPA, and (3) Wait-List Usual Care Control. Participants in the two mAPA groups will continue to receive usual care while participants in the Usual Care Control group will be re-randomized into either mAPA group after 1-month follow-up. Compared to our pilot study, this is a larger scale and longer term RCT to be conducted in Maryland and Nevada ensuring sites that will be inclusive and representative of diverse populations. Our long-term goal is to eliminate pain care disparities and reduce our society’s reliance on opioids to manage pain. Leveraging technology, the proposed study will help advance mAPA, a novel, easy-to-initiate, rapid, safe, and non-pharmacological tool incorporated in a self-management plan to habitually manage pain in real-world settings.