Temporomandibular Joint Dysfunction Syndrome Clinical Trial
Official title:
Tailored Self-Management of TMD Pain Using Health Information Technology
The purpose of this pilot project is to determine the feasibility and acceptability of proposed methods for a subsequent clinical trial of a tailored self-management program (PACT) designed to decrease pain in participants with temporomandibular disorders (TMD). The PACT program is a personalized program of exercise and behavioral changes implemented through a web-based program supported by a health coach. For this feasibility and acceptability study, 80 adults with TMD pain will be randomized either to the PACT program or to traditional self-care.
The primary study objectives of the PACT study are two-fold:
1. Evaluate the feasibility of methods to conduct a full-scale multi-site randomized
clinical trial comparing PACT self-management with traditional self-care for TMD. The
study will also evaluate strategies to: identify, recruit, consent, and enroll eligible
subjects into both groups meeting target goal; evaluate adherence to intervention and
identification of barriers; evaluate adherence to outcomes assessment, and evaluate the
on-line web-site functionality and acceptability.
2. To demonstrate ability to accurately capture outcome measures to be used in the
multi-site study.
Primary study objective: Recruitment is measured through achievement of target sample, number
of patients identified that meet eligibility criteria, and number (%) of subjects consenting
compared with total contacted.
Intervention adherence is measured by: number of participants enrolled in both groups, number
of participants accessing on-line materials, completion of practice logs, and identification
of self-reported barriers of participation in self-care. Outcome adherence is measured by the
number of participants who complete the baseline assessment, complete the two and four month
follow-up assessments, complete the program evaluation, and complete qualitative post-study
interview. Website acceptability is measure by identification of problems and barriers during
use and quality and ease of use at the post-intervention evaluation.
Second objective: Efficacy of the program is measured by self-reported outcome assessments.
The primary outcomes include TMD symptoms, jaw functioning, and emotional functioning.
Secondary outcomes measures include symptom severity with the temporal aspects of pain, pain
interference, and patient ratings of improvement. Additional information on mediators and
modifiers will also be gathered to help inform the how and why the intervention has an
effect. Mediators will be measured to identify factors that help explain why PACT may have an
effect including self-efficacy, patient activation, exercise level, sleep quality, and social
support. Contextual process factors to identify in whom the intervention does and does not
work include disability status, catastrophizing, depression, repetitive strain from oral
habits, and perceived stress.
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