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Leveraging mHealth to deliver integrated pain-CBT, opioid monitoring, and self-management support for advanced cancer patients coping with chronic pain

Leveraging mHealth to deliver integrated pain-CBT, opioid monitoring, and self-management support for advanced cancer patients coping with chronic pain
利用移动医疗为应对慢性疼痛的晚期癌症患者提供综合疼痛 CBT、阿片类药物监测和自我管理支持
批准号:
10609388
负责人:
Desiree R Azizoddin
金额:
$15.15万
依托单位国家:
美国
项目类别:
财政年份:
2022
资助国家:
美国
项目状态:
未结题
起止时间:
2022-05-01 至 2025-04-30
关键词:
Active LearningAddressAdvanced Malignant NeoplasmAffectAlgorithmsAnalgesicsBeliefCancer CenterCancer Pain ManagementCancer PatientCaringCellular PhoneChronicChronic Cancer PainClinicCognitiveCognitive TherapyComplementComplexComplicationConstipationConsumptionData CollectionDevelopmentDiseaseDistressEducationElementsEmotionsEnsureExerciseFeedbackFrightFutureGoalsGrowthHealth TechnologyInterventionInterviewLibrariesLifeMalignant - descriptorMalignant NeoplasmsMediatorMedicalMedication ManagementMobile Health ApplicationModelingMonitorMoodsMultimediaNociceptionNon-MalignantOpioidOutcome StudyOutpatientsPainPain ResearchPain intensityPain managementPalliative CareParentsPatientsPersonsPharmacological TreatmentPharmacotherapyPilot ProjectsPopulationPsychological FactorsPublic HealthQuality of lifeRandomizedRelaxationReportingScheduleSelf DirectionSelf EfficacySelf ManagementSelf-ExaminationSeriesSeveritiesSleepSocial Well-BeingStressStructureSurveysSurvivorsSymptomsSyndromeTechnologyTestingTherapeuticTimeTitrationsUnited States National Institutes of HealthVulnerable Populationsacceptability and feasibilityaddictionarmbiological adaptation to stressbiopsychosocialcancer painchronic painchronic pain managementchronic pain patientcopingdesigndisabilityefficacy trialend of lifeexperienceimprovedinsightintervention effectlaxativemHealthmobile computingmultidisciplinarynegative affectnew technologynovelopioid usepain outcomepain perceptionpain self-managementpalliatepharmacologicprogramspsychoeducationpsychoeducationalpsychologicpsychological outcomespsychological symptomrecruitresponseretention ratesatisfactionsmartphone applicationsymptom self managementtelehealththerapy designtrendusability

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中文摘要
翻译
项目摘要 疼痛影响大约三分之二的晚期癌症患者,接近90%的比例接近100%。 生命终结尽管药物治疗对于缓解慢性癌症疼痛至关重要,但心理治疗 这些因素也显著影响疼痛结果。疼痛的认知行为疗法(CBT) 对慢性癌症和非恶性疼痛有效。不幸的是,疼痛CBT在其传统的格式(60- 分钟,12-16周的面对面治疗)对于晚期癌症患者是不现实的。有效 生物心理社会癌症疼痛管理需要大量的适应,以满足现实生活的需要, 晚期癌症患者,理想情况下应结合药物治疗支持。鉴于广阔的 需要,移动的健康技术是一个有前途的战略,提供并最终传播简短的,痛苦的CBT 对癌症患者的干预。 我们的目标是通过调整和整合疼痛-CBT来改善晚期癌症患者的疼痛自我管理 我们现有的移动健康项目旨在支持患者的药物管理。子公司 STAMP(智能手机技术,以减轻恶性疼痛)是一种面向患者的智能手机, 支持日常症状和阿片类药物监测的应用程序,并提供量身定制的疼痛心理教育, 建议.我们有一个战略机会来适应和整合疼痛CBT,以创造新的移动健康干预 协调对晚期癌症疼痛的心理和医疗支持。利用移动的技术, 我们将通过以下方式模拟疼痛-CBT的治疗体验:1)展示先进的癌症特异性多媒体 心理教育内容,2)制定时间表,每天提供简短的教学,3)促进洞察力 通过调查和量身定制的反馈进行建设,以及4)通过游戏化的认知刺激主动学习 重组工作和录音放松。在目标1:我们将补充我们的多媒体图书馆, 癌症疼痛心理教育和适应疼痛CBT内容为简短的移动健康交付特定于先进的 癌症,同时整合临床医生和患者(n=20)的反馈。目标2:25例慢性 晚期癌症的疼痛将使用STAMP+CBT 6周。调查结果将阐明应用程序使用的可行性 以及为更大规模的未来疗效试验(R 01)收集数据,以便探索疼痛的有意义趋势, 心理中介和护理利用。如果证明有效,这种疼痛CBT和阿片类药物管理 干预有很大的潜力来扩大规模,使生物心理社会疼痛治疗可用于人口, 不成比例地患有慢性疼痛,并且几乎无法获得非药物疼痛管理 治疗。
英文摘要
Project Summary Pain affects approximately two thirds of patients with advanced cancer, with rates approaching 90% near the end-of-life. Although pharmacotherapy is vitally important to alleviating chronic cancer pain, psychological factors also substantially influence pain outcomes. Cognitive Behavioral Therapy for pain (pain-CBT) is effective for chronic cancer and non-malignant pain. Unfortunately, pain-CBT in its traditional format (60- minute, in-person sessions for 12-16 weeks) is unrealistic for advanced cancer patients. Effective biopsychosocial cancer pain management requires substantial adaptation to meet the real-life needs of advanced cancer patients and should ideally integrate with pharmacotherapy support. Given the expansive need, mobile health technology is a promising strategy to deliver and ultimately disseminate brief, pain-CBT interventions to cancer patients. Our goal is to improve advanced cancer patients' pain self-management by adapting and integrating pain-CBT into our existing mHealth program designed to support patients' pharmacologic management. Our parent intervention, STAMP (Smartphone Technology to Alleviate Malignant Pain) is a patient-facing smartphone application that supports daily symptom and opioid monitoring, and delivers tailored pain psychoeducation and advice. We have a strategic opportunity to adapt and integrate pain-CBT to create novel mHealth intervention that harmonizes psychological and medical support for advanced cancer pain. Leveraging mobile technology, we will simulate the therapeutic experience of pain-CBT by 1) presenting advanced cancer-specific, multimedia psychoeducational content, 2) developing schedules to deliver daily, brief didactics, 3) facilitating insight building via surveys and tailored feedback, & 4) stimulating active learning through gamified cognitive restructuring exercises and audio-recorded relaxations. In Aim 1: We will supplement our multi-media library of cancer pain psycho-education and adapt pain-CBT content for brief mHealth delivery specific to advanced cancer, while integrating clinician and patient (n=20) feedback throughout. In Aim 2: 25 patients with chronic pain from advanced cancer will use STAMP+CBT for 6 weeks. Findings will illuminate feasibility of app use and data collection for a larger future efficacy trial (R01), allowing for exploration of meaningful trends in pain, psychological mediators, and care utilization. If proven effective, this pain-CBT and opioid management intervention has great potential to scale and make biopsychosocial pain treatment available to a population that suffers disproportionately from chronic pain and has little access to non-pharmacologic pain management treatments.
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Integrating pain-CBT into an mHealth analgesic support intervention for patients with chronic pain from advanced cancers
Integrating pain-CBT into an mHealth analgesic support intervention for patients with chronic pain from advanced cancers
Leveraging mHealth to deliver integrated pain-CBT, opioid monitoring, and self-management support for advanced cancer patients coping with chronic pain
Admin Supplement: Integrating pain-CBT into an mHealth analgesic support intervention for patients with chronic pain from advanced cancers
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