Virtual Single-Session "Empowered Relief" Group Intervention for Chronic Pain

Sponsor
Stanford University (Other)
Overall Status
Completed
CT.gov ID
NCT04546685
Collaborator
(none)
104
1
2
9.3
11.2

Study Details

Study Description

Brief Summary

Pain is naturally aversive and often distressing. Pain coping and self-regulatory skills have been shown to effectively reduce pain-related distress and other symptoms. The purpose of the study is to pilot a single-session videoconference-delivered pain education class (Empowered Relief) for bolstering pain and symptom management in people with chronic pain. Class participants learn skills and develop a personalized plan to use the skills every day. The study will follow participants 3 months by administering 5 follow-up surveys at 1 & 2 weeks and 1 month, 2 months, and 3 months post-treatment to determine whether the class confers long-term benefits across various aspects of health.

Condition or Disease Intervention/Treatment Phase
  • Other: Usual Care
  • Behavioral: Empowered Relief
N/A

Detailed Description

Inadequate treatment of chronic pain is an interrelated public health crisis. An Institute of Medicine Pain Report noted that chronic pain affects ~100 million American adults and costs $635 billion annually. There is a critical need to better integrate behavioral medicine and self-management strategies to treat pain comprehensively and apply a 'whole person' approach to pain care. To date, the U.S. lacks scalable behavioral medicine for pain thereby underscoring the need for solutions that are accessible, low-cost, and low-burden.

Poor access to behavioral pain care contributes substantially to chronic pain burden because patient-level factors-such as pain catastrophizing-remain untreated and the multidimensional nature of pain ignored. Pain catastrophizing - a pattern of negative cognitive and emotional responses to actual or anticipated pain is a potent prognostic for pain and disability trajectories. Pain catastrophizing is effectively treated with 8-week skills-based group cognitive behavioral therapy for chronic pain (pain-CBT), yet pain-CBT is inaccessible to most Americans due to few trained therapists and the burdens of treatment time and costs. Efficient, effective solutions are urgently needed to provide access to skills-based behavioral medicine that equips patients to reduce pain catastrophizing and better self-manage chronic pain. To address this unmet need, the investigators developed and tested a single-session, 2-hour, pain-CBT skills-based behavioral medicine class ("Empowered Relief") to reduce pain catastrophizing and pain correlates. In a 3-arm randomized controlled trial involving in-person delivery of treatments, results suggest that Empowered Relief was non-inferior to 8-week cognitive behavioral therapy and superior to a health education class for reducing pain catastrophizing and improving multiple secondary outcomes at 3 months post-treatment in individuals with chronic low back pain.

In the current study, Empowered Relief is being translated from class delivery to an online format. Implementing a 2-arm randomized controlled trial of a single-session, video conference-based, group-intervention version of "Empowered Relief" and comparing it to Usual Care in mixed etiology chronic pain. Outcome 1, Empowered Relief will be superior to the Usual Care for reducing pain catastrophizing at the 1-month follow-up. Outcome 2, Empowered Relief will be superior to Usual Care for reducing pain bothersomeness and sleep disturbance at the 1-month follow-up. Outcome 3, Empowered Relief will be superior to Usual Care for reducing pain intensity, anxiety, depression, physical function at the 1-month follow-up. Patient outcomes will be longitudinally tracked at weeks 1 & 2 and months 1, 2, & 3 after the intervention session.

Study Design

Study Type:
Interventional
Actual Enrollment :
104 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
Efficacy of a Single-Session "Empowered Relief" Videoconference-Delivered Group Intervention for Chronic Pain
Actual Study Start Date :
Sep 28, 2020
Actual Primary Completion Date :
Jul 7, 2021
Actual Study Completion Date :
Jul 7, 2021

Arms and Interventions

Arm Intervention/Treatment
Other: Usual Care (waitlist)

Participants will continue their usual clinical care.

Other: Usual Care
Participants who are randomized in the waitlist or usual care do not receive the study intervention and will be instructed to continue with the care they would normally receive as part of their ongoing clinical care. Upon completion of the 3-month study, participants in the waitlist will be invited to enroll in the Empowered Relief class.
Other Names:
  • Waitlist
  • Experimental: Single-Session Pain Relief Skills Class (Empowered Relief)

    A 2-hour class that will be delivered by a clinical psychologist via videoconference to participant cohorts.

    Behavioral: Empowered Relief
    The participants will attend the Empowered Relief class offered online via Zoom. The class is designed to treat pain catastrophizing in people with chronic pain. Class participants will learn self-management skills and develop a personalized plan to use the skills every day. Participants will receive an audio file (Relaxation Response) post-class. The class provides patients rapid access to actionable skills for symptom management and pain relief.
    Other Names:
  • Single-Session Pain Relief Skills Class
  • Outcome Measures

    Primary Outcome Measures

    1. Pain Catastrophizing Score; measured with Pain Catastrophizing Scale [1 month]

      Empowered Relief will be superior to the Usual Care for reducing pain catastrophizing scores after the intervention.

    Secondary Outcome Measures

    1. Pain bothersomeness and PROMIS sleep disturbance [1 month]

      Empowered Relief will be superior to Usual Care for reducing pain bothersomeness and sleep disturbance

    Other Outcome Measures

    1. Pain intensity, PROMIS anxiety, PROMIS depression,PROMIS physical function [1 month]

      Empowered Relief will be superior to Usual Care for reducing pain intensity, anxiety, depression, and physical function

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Age 18+

    2. Chronic pain (pain that occurs on at least half of the days of 6 months or more)

    3. English fluency

    4. Ability to adhere to and complete study procedures

    Exclusion Criteria:
    1. Cognitive impairment, or non-English speaking.

    2. Previous participation in the Empowered Relief class.

    3. On-going legal action or disability claim

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 1070 Arastradero Rd Mountain View California United States 94304-1334

    Sponsors and Collaborators

    • Stanford University

    Investigators

    • Principal Investigator: Beth Darnall, PhD, Stanford University

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Beth Darnall, Associate Professor, Stanford University
    ClinicalTrials.gov Identifier:
    NCT04546685
    Other Study ID Numbers:
    • 31191
    First Posted:
    Sep 14, 2020
    Last Update Posted:
    Jul 8, 2021
    Last Verified:
    Jul 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Jul 8, 2021