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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06387290
Other study ID # 00172836
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date May 6, 2024
Est. completion date May 1, 2030

Study information

Verified date May 2024
Source University of Utah
Contact Thanusha Puvananayagam, MPH
Phone 732-235-4341
Email puvanath@rwjms.rutgers.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The primary aim of this implementation-effectiveness trial is to examine the effectiveness of Mindfulness-Oriented Recovery Enhancement (MORE) and patient-centered chronic pain management visits in primary care as interventions to reduce chronic pain, improve quality of life, and reduce opioid-related harms among chronic pain patients on long-term opioid therapy.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 300
Est. completion date May 1, 2030
Est. primary completion date May 1, 2030
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age 18 + - Current chronic pain diagnosis (pain for =3 months) determined by physician assessment - Current use of opioids for =3 months - Score >=3 on the Pain Enjoyment General Activity scale - Score >=9 on the Current Opioid Misuse Measure OR lifetime psychiatric or substance use disorder diagnosis OR benzodiazepine use OR history of overdose OR physician determination that risks of opioid use may outweigh the benefits of opioid use Exclusion Criteria: - Chronic pain due to a cancer diagnosis - Active suicidal intent, schizophrenia, psychotic disorder - Prior experience with Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, Mindfulness-Based Relapse Prevention, or Mindfulness-Oriented Recovery Enhancement

Study Design


Intervention

Behavioral:
Mindfulness Oriented Recovery Enhancement
Mindfulness-Oriented Recovery Enhancement (MORE) is a group behavioral intervention that unites mindfulness training, cognitive reappraisal, and positive psychological principles into an integrative therapeutic approach.
Patient-Centered Chronic Pain Management Visits
Participant will meet with their primary care provider for patient-centered care and shared decision making while discussing their chronic pain management strategy (e.g., opioid analgesics).

Locations

Country Name City State
United States Rutgers University Primary Care Clinics New Brunswick New Jersey
United States University of Utah Primary Care Clinics Salt Lake City Utah

Sponsors (2)

Lead Sponsor Collaborator
University of Utah Rutgers University

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Decentering Change in Decentering from baseline through study completion will be measured with the Metacognitive Processes of Decentering (MPODS) scale. Scores range from 15 to 75, with higher scores indicating more decentering. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Other Mindful Reappraisal of Pain Sensations Change in Mindful Reappraisal of Pain Sensations from baseline through study completion will be assessed with the Mindful Reappraisal of Pain Sensations (MRPS) Scale. Scores range from 0 to 54, with higher scores indicating greater mindful reappraisal of pain sensations. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Other Savoring Change in savoring measured by the Brief Savoring Inventory, range from 4 to 20, higher scores indicating more use of savoring. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Other Reappraisal Change in reappraisal measured by the Emotion Regulation Questionnaire, range from 6 to 42, with a higher score indicating more use of reappraisal. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Primary Opioid Misuse Opioid misuse as evidenced by triangulated aggregate of self-reported Current Opioid Misuse Measure and/or interview via Addiction Behaviors Checklist and/or urine screen Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Primary Chronic Pain Change in Chronic pain will be measured from baseline through study completion using the Pain, Enjoyment of Life, and General Activity Scale (PEG). Scoring can be determined in one of two ways:
A total sum score from 0 to 30, with higher scores indicating more severe pain and pain-related interference with life and activities
Dividing the sum of responses to all three items by 3 to get the mean score on a scale of 0-10, with higher scores indicating more severe pain and pain-related interference with life and activities.
Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Secondary Change in Quality of Life Change in Quality of Life will be measured from baseline through study completion using the Patient Reported Outcomes Measurement Information System (PROMIS-29) to assess physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, pain interference, and pain intensity. Scores range from 4-20 in each domain, with higher scores indicating more impairment in that domain. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Secondary Opioid Dosing Opioid dose will be assessed from baseline through study completion by Timeline Follow Back (TLFB) interview. Opioid dose will be converted to morphine-equivalent using equianalgesic conversions. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Secondary Opioid Craving Opioid craving will be assessed with validated numeric rating scale items (Garland et. al, 2022) delivered by ecological momentary assessment. Daily from baseline through month 4
Secondary PTSD Symptoms PTSD Symptoms will be measured from baseline through study completion using the Posttraumatic Stress Disorder Checklist (PCL-5). Scores range from 0-80, with higher scores indicating overall higher PTSD symptom severity. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Secondary Depression Depression symptoms will be measured from baseline through study completion using the nine-item Patient Health Questionnaire (PHQ-9). Scores range from 0-27, with higher scores indicating more severe symptoms of depression. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
Secondary Generalized Anxiety Generalized Anxiety will be measured from baseline through study completion using the Generalized Anxiety Disorder 7 (GAD-7). Scores range from 0-21, with higher scores indicating more severe symptoms of anxiety. Change from baseline through study completion (assessed at 3-, 6-, 9-, and 12-months follow-up)
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