Chronic Pain Clinical Trial
Official title:
Secondary Prevention With the Mobile PTSD Coach App to Improve Health Outcomes and the Continuity of Care Following Traumatic Physical Injury: A Randomized Controlled Trial
This project is a preliminary randomized controlled trial testing the potential impact of the PTSD Coach mobile application at reducing posttraumatic stress and pain symptoms among acutely injured trauma patients. Immediately following the injury, patients will be randomly assigned to use the PTSD Coach app, or to the treatment as usual condition.
Traumatic injury is the leading cause of mortality in the U.S. for young people, and a source
of long-term morbidity in all ages. A majority of trauma patients report chronic pain (CP)
and disability at 4-months (30%- 79%) and 12-months (63%) post-injury. Maladaptive
psychological processes have a stronger association with the transition to CP than does
injury severity. Posttraumatic stress disorder (PTSD) symptoms (e.g., intrusions, avoidance
and hyperarousal) occur in up to 22% of post-injury patients and herald the transition from
acute to CP. Although psychological interventions can modify PTSD symptoms, and reduce CP, it
is unknown if early intervention to prevent PTSD symptoms can prevent post-injury CP
altogether. "PTSD Coach" is a publicly available, free, mobile app that provides scalable and
psychosocial support modeled on principles of cognitive-behavioral therapy. PTSD Coach has
helped Veterans and civilians to manage PTSD.
This project will test whether PTSD Coach can reduce post-injury maladaptive psychological
processes and thereby prevent post-injury CP. The preventive intervention will be targeted
towards those at the highest-risk of developing PTSD.
The investigators propose to test the efficacy of the PTSD Coach app vs. treatment as usual
(TAU) among a sample of acute physical injury patients, to: 1) Determine engagement with PTSD
Coach, by measuring frequency of use over 4-weeks and assessing ratings of usefulness and
qualitative feedback: it is expected that >80% of PTSD Coach users will use the app at least
once a week, and will rate it as at least somewhat helpful; 2) Estimate effect on CP symptoms
by measuring PTSD and pain intensity at 1- and 3-months. The effect of the intervention on
pain interference, disability, and coping self-efficacy will also be explored.
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