Treating Comorbid Pain and Depression in HIV+ Individuals

NCT ID: NCT02766751

Last Updated: 2021-06-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

187 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-15

Study Completion Date

2021-05-31

Brief Summary

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This study is designed to look at two different programs that may help people who are HIV+ and have pain and depression. The investigators are trying to understand how to help people learn to live better lives even with these chronic illnesses.

Detailed Description

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The primary aim of this RCT is to evaluate the HIVPass intervention. HIV+ participants (n=236) with chronic pain and depression will be recruited at primary care HIV Clinics through posted advertisements in the waiting rooms of the PCP offices and by physician referral. After an initial phone study screen, research staff will meet with interested individuals in their PCP offices for informed consent, baseline interview and randomization into one of two study groups (Health Education or HIVPass Counseling). Seven intervention sessions (HE or HIVPASS) will occur during the first 3 months of study participation. For all participants, the first session is a collaborative in-person joint session with the participant, his/her PCP and the study BHS. Session 2 is conducted immediately after this collaborative session, and is also in-person. Sessions 3-7 are conducted by phone. Follow-up assessment interviews will be at months 1, 2, 3 (post-intervention), 4, 6, 9 and 12.

Conditions

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HIV Depression Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Health Education

The seven sessions will cover: 1) nutrition (2 sessions), 2) sleep hygiene, 3) building immunity (e.g., how to avoid colds/flu), 4) injury/disease prevention (e.g., seat belts, sunscreen, when to get regular check-ups/screenings etc.), 5) benefits of exercise/cardiac health, 6) alternative medicine (massage, acupuncture). These sessions will be primarily didactic and consist of health education, followed by discussion as to how this information compares to that which the participants may have been exposed to in the past.

Group Type PLACEBO_COMPARATOR

Health Education

Intervention Type BEHAVIORAL

The 7-sessions of Health Education is provided to individuals randomized to the Health Education study arm.

HIVPASS

Over 7 sessions, the interventionist and the participant will explore the relationship between pain, depressive symptoms, and HIV. General information about pain, HIV and depression will be discussed, as will avoidance of physical activity. Psychoeducation about these areas will be tied to the participant's stated life goals, and exposure exercises and goal lists will be developed. Later sessions will integrate continued efforts towards reaching goals and reducing avoidance. A release of information will be obtained from the participant to allow study session chart notes to be placed in the medical record at the participant's PCP office and to allow the PCP and the study interventionist to discuss treatment coordination.

Group Type EXPERIMENTAL

HIVPASS

Intervention Type BEHAVIORAL

The 7-session HIVPASS intervention is provided to individuals randomized to the HIVPASS study arm.

Interventions

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HIVPASS

The 7-session HIVPASS intervention is provided to individuals randomized to the HIVPASS study arm.

Intervention Type BEHAVIORAL

Health Education

The 7-sessions of Health Education is provided to individuals randomized to the Health Education study arm.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Chronic Pain (pain duration for at least six months with a mean score of greater than 3.5 on the BPI Pain Interference Scale)
* Pain severity \> or equal to 4 on a Numeric Rating Scale indicating "average pain in the last week"
* At least one trial of PCP-recommended medication (i.e. acetaminophen, NSAIDS, muscle relaxants) judged through interviews with patients and PCPs
* Quick Inventory of Depression Symptoms (QIDS) score of ≥ 9 (depression severity)
* Stable dose of an antidepressant, if using, for the previous 1 months
* Age \> or equal to 18
* HIV+
* Planning to live in the area for the next 6 months
* Access to a telephone that is typically working.

Exclusion Criteria

* In psychotherapy or a multidisciplinary pain management program
* Planned surgery in the next 6 months
* Pain thought due to cancer
* Current mania
* Past year chronic psychotic condition
* Excessive substance use (Use of cocaine, heroin, or non-prescribe opioids 15 days per month or more; binge alcohol use 4 days per month or more)
* Suicidality requiring immediate attention
* Pregnancy or planned pregnancy in the next 6 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Butler Hospital

OTHER

Sponsor Role lead

Responsible Party

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Michael Stein, MD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michael Stein, MD

Role: PRINCIPAL_INVESTIGATOR

Butler Hospital

Locations

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Boston University/Boston Medical Center

Boston, Massachusetts, United States

Site Status

Hennepin Healthcare

Minneapolis, Minnesota, United States

Site Status

Butler Hospital

Providence, Rhode Island, United States

Site Status

The Miriam Hospital

Providence, Rhode Island, United States

Site Status

Countries

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United States

References

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Uebelacker LA, Pinkston MM, Busch AM, Baker JV, Anderson B, Caviness CM, Herman DS, Weisberg RB, Abrantes AM, Stein MD. HIV-PASS (Pain and Sadness Support): Randomized Controlled Trial of a Behavioral Health Intervention for Interference Due to Pain in People Living With HIV, Chronic Pain, and Depression. Psychosom Med. 2023 Apr 1;85(3):250-259. doi: 10.1097/PSY.0000000000001172. Epub 2023 Feb 3.

Reference Type DERIVED
PMID: 36799731 (View on PubMed)

Pinkston MM, Busch AM, Stein M, Baker J, Caviness C, Herman D, Weisberg R, Abrantes AM, Uebelacker LA. Improving functioning in HIV+ patients with chronic pain and comorbid depression: Protocol for a randomized clinical trial testing a collaborative behavioral health intervention based on behavioral activation. Contemp Clin Trials. 2022 Aug;119:106842. doi: 10.1016/j.cct.2022.106842. Epub 2022 Jun 28.

Reference Type DERIVED
PMID: 35777696 (View on PubMed)

Other Identifiers

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840019

Identifier Type: -

Identifier Source: org_study_id

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