Purpose

The investigator aims to conduct a feasibility randomized controlled trial (RCT) (N=50) to test the feasibility, acceptability, and credibility of an asynchronous web-based mind-body intervention (Toolkit for Resilient Life beyond Pain and Substance Use; Web-TIRELESS) versus web-based minimally enhanced usual care (Web-MEUC) among adult patients with a painful non-traumatic upper-extremity condition(s) (PNUC) and commorbid risky substance use. Deliverables: [1] Adapt and refine open pilot protocol, patient recruitment, and other study materials. [2] Assess the feasibility, acceptability, and credibility of Web-TIRELESS and Web-MEUC in preparation for future research.

Conditions

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. Outpatient adults seeking care in the Hand and Arm Center 2. Diagnosed with a non-traumatic painful upper-extremity condition (NPUC) 3. Pain score > 4 on the Numerical Rating Scale (NRS) 4. Risky substance use (scores >10 and <27 for alcohol, and >3 and <27 for cannabis, cocaine, amphetamine-type stimulants, inhalants, sedatives, hallucinogens, opioids, tobacco products, and e-cigarette on The World Health Organization's - Alcohol, Smoking and Substance Involvement Screening Test [WHO-ASSIST]) 5. Owns a smartphone, laptop, or computer with internet access 6. Age ≥18yr 7. English fluency 8. Ability and willingness to participate in a live video focus group and the following asynchronous Web-based intervention

Exclusion Criteria

  1. Participation in mind-body or specialized substance abuse treatment in the past 3 months 2. Practice of mindfulness >45 minutes/week in the past 3 months 3. Psychotropic medications (e.g. antidepressants) changed in the past 3 months 4. Serious untreated mental illness (e.g., Schizophrenia) 5. Suicidal ideation with intent or plan 6. Pregnancy 7. Secondary gains that may bias motivation (e.g., pending disability claim), 8. Moderate to severe cognitive impairment (score ≥4 on the Short Portable Mental Status Questionnaire (SPMSQ)) 9. History of surgery for the presented NPUC within the past 6 months OR future plans for surgery.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Single (Participant)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Web-TIRELESS
A 4-session, asynchronous, web-based mind-body pain and substance use management intervention.
  • Behavioral: Web-TIRELESS
    This is a self-administered web-based intervention that consists of 4 on-demand sessions, each ~30 minutes long, that teach mind-body skills, cognitive-behavioral strategies (e.g., reframing, pain and substance use urge surfing), activity pacing, acceptance and commitment skills, and psychoeducation on the association between substance use and pain. The program aims to increase patients' physical and emotional functioning and decrease pain intensity and maladaptive substance use behaviors.
Active Comparator
Web-MEUC
Open access to a web-based pamphlet containing brief, educational information and coping techniques.
  • Other: Web-MEUC
    An educational information web-based pamphlet, containing brief, summarized information tailored for the respective patient population that follows topics including the trajectory of pain and adaptation after non-traumatic painful upper extremity conditions, the role of relaxation strategies to manage pain, and the importance of returning to engagement in activities of daily living.

Recruiting Locations

Massachusetts General Hospital
Boston 4930956, Massachusetts 6254926 02114
Contact:
Principal Investigator
617-643-7641
jbakhshaie@mgh.harvard.edu

More Details

Status
Recruiting
Sponsor
Jafar Bakhshaie

Study Contact

Jafar Bakhshaie, MD, PhD
617-643-7641
jbakhshaie@mgh.harvard.edu

Detailed Description

Aim: Conduct a feasibility randomized controlled trial (RCT) (N=50) of Web-TIRELESS versus Minimally Enhanced Usual Care (Web-MEUC)-both of which are web-based-among patients with painful nontraumatic upper extremity conditions and comorbid risky substance use (N=50), to demonstrate the feasibility of recruitment procedures and data collection; and the feasibility, credibility, and acceptability (adherence, retention, fidelity, and satisfaction) of Web-TIRELESS and Web-MEUC. We will use this mixed-methods information to assess the primary outcomes and optimize both programs and study methodology in preparation for research. Participants are randomized to either Web-TIRELESS or Web-MEUC and given access to the respective program for approximately 5 weeks to review and complete the assigned material. Both groups are given education material to help improve pain and substance use urge coping. There are 3 assessment points consisting of self-report surveys: baseline, post-program, and 6-month follow-up.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.