The goal of this proposed project is to optimize the adaptive psychological intervention and assess the feasibility and acceptability. The long-term objective of this line of research is to evaluate whether an adaptive psychological intervention delivered after a musculoskeletal injury is effective in preventing the development of chronic pain and long-term opioid use.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
80
Education about long-term opioid use and a mindfulness strategy
Four sessions composed of education, mindfulness, and acceptance-based strategies.
Recommendations will be provided to taper opioid use.
Opioid use
Whether patient was using opioids
Time frame: 90-day follow-up
Morphine Dose Equivalent (MDE)
Dose of opioid use in MDEs
Time frame: 90-day follow-up
Presence of chronic pain
Whether a patient reports experiencing pain from the injury
Time frame: 90-day follow-up
Pain severity
On a 0 (no pain) to 10 (worst pain) scale, patients rate their current pain and average, least, and worst pain over the previous week.
Time frame: 90-day follow-up
Pain interference
Participants report on a 0 (does not interfere) to 10 (completely interferes) scale how much the pain interferes across a variety of daily activities.
Time frame: 90-day follow-up
Mindfulness
The Mindful Attention Awareness Scale (MAAS) is a validated, 15 item measure that questions how often a patient engages in mindfulness experiences on a 1 (almost always) to 6 (almost never) point scale; scores are summed to produce a total score. Scores can range from 15-90 with higher scores indicating greater mindfulness.
Time frame: 90-day follow-up
Pain acceptance
The Chronic Pain Acceptance Questionnaire (CPAQ) is 20 items with two validated subscales: Activities Engagement and Pain Willingness. A total score is achieved by summing these two subscales. Items are on a 0 (Never True) to 6 (Always True) Likert Scale. Scores range from 0 to 120 with higher scores indicating greater acceptance.
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Time frame: 90-day follow-up
Depression
The Patient Health Questionnaire (PHQ-9) is a 9-item measure that assesses severity of depressive symptoms. Scores range from 0 to 27 with higher scores indicating greater severity of symptoms.
Time frame: 90-day follow-up
Anxiety
The Generalized Anxiety Disorder (GAD-7) assesses severity of anxiety symptoms. Scores range from 0 to 21 with higher scores indicating greater severity of symptoms.
Time frame: 90-day follow-up
Sleep
The Insomnia Severity Index (ISI) measures sleep difficulty. The ISI has 7-items on a 0 to 4. Scores range from 0 to 28 with higher scores indicating greater severity of sleep problems.
Time frame: 90-day follow-up
Impact of Events Scale Revised
This 22-item measure asks participants to respond to their level of distress regarding a specified event on a 0 to 4 scale over the past 7 days. Scores range from 0 to 88 with higher scores indicating higher distress.
Time frame: 90-day follow-up
Opioid misuse
The Current Opioid Misuse Measure (COMM) is a 17-item measure that asks participants about behaviors associated with opioid misuse on a 0 to 4 scale. Scores range from 0 to 68. Scores of 9 or greater are considered positive for opioid misuse.
Time frame: 90-day follow-up