Connected Health to Decrease Opioid Use in Patients With Chronic Pain

NCT ID: NCT04013529

Last Updated: 2021-10-27

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-31

Study Completion Date

2020-09-15

Brief Summary

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The objective of this pilot study to evaluate if behavioral incentives applied at the VA Medical Center can appreciably increase participation in activities that promote mobility, and subsequently reduce pain severity and opioid use.

Detailed Description

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Chronic pain is a highly prevalent and costly condition in the US. An estimated 88.5 million adults suffer from daily pain, resulting in estimated cost of $500- 635 biJlion due to lost productivity, and $261-300 billion in health care expenditures. To manage their chronic pain, 5 to 8 million Americans take an opioid medication daily. Yet , the risks associated with ongoing opioid prescription , including overdose, abuse and diversion, temper their analgesic effects.

Opioids are not more effective in the treatment of chronic pain compared with non-opioid approaches. Current guidelines have adapted to the evidence, recommending opioid-sparing approaches for treating patients with chronic pain, and tapering for those on higher doses to safer levels of use. Tapering opioids, however, requires replacing them with effective non-opioid strategies. Improving mobility has been shown to improve pain and decrease medication use among patients chronically prescribed opiates. Concurrently, financial incentives and the use of behavioral incentives have been shown to promote mobility.

Appreciating the gains in health outcomes that can be made with "connected health" approaches, we propose a novel pilot study designed to evaluate if technology enabled care (TEC) strategies and financial incentives can improve patient mobility in our chronic pain population, reduce pain and decrease opioid use . Our primary aim is to determine if chronic pain patients who receive TEC-enhanced treatment with financial incentives demonstrate increased participation in activities that promote mobility (physical therapy, yoga, tai chi) in comparison to patients receiving usual care. Secondary outcomes will include whether increased activity participation also reduces pain severity and opioid use, and improves function and increases the number of daily steps taken. The results of this pilot will enable us to determine what strategies are effective at increasing mobility and if these gains translate into reduced pain and decreased opioid use.

Conditions

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Chronic Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Control

Participate in technology-enabled care without regret lottery

Group Type PLACEBO_COMPARATOR

Way to Health technology enhanced care

Intervention Type BEHAVIORAL

Subjects receive text reminders to reach activity goals.

Experimental

Participate in technology-enabled care with regret lottery

Group Type EXPERIMENTAL

Regret lottery

Intervention Type BEHAVIORAL

Subjects who achieve step goals are entered into a lottery in which they can win a financial incentive of $30 or $100.

Way to Health technology enhanced care

Intervention Type BEHAVIORAL

Subjects receive text reminders to reach activity goals.

Interventions

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Regret lottery

Subjects who achieve step goals are entered into a lottery in which they can win a financial incentive of $30 or $100.

Intervention Type BEHAVIORAL

Way to Health technology enhanced care

Subjects receive text reminders to reach activity goals.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Chronic non-malignant pain
* High dose opioid therapy
* Possession of activated cell phone with text messaging capabilities
* Willingness to comply with study requirements

Exclusion Criteria

* Pain of malignant origin
* Sensory impairments precluding use of text messaging and activity tracker
* Physical disability precluding improvements in physical activity
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Corporal Michael Cresenz VA Medical Center

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Compton P, Chaiyachati KH, Dicks T, Medvedeva E, Chhabra M. A randomized controlled trial to evaluate a behavioral economic strategy for improving mobility in veterans with chronic pain. PLoS One. 2021 Oct 11;16(10):e0257320. doi: 10.1371/journal.pone.0257320. eCollection 2021.

Reference Type DERIVED
PMID: 34634064 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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01758

Identifier Type: -

Identifier Source: org_study_id