Integrated Telehealth Intervention to Reduce Chronic Pain and Unhealthy Drinking Among People Living with HIV: Protocol for a Randomized Controlled Trial

Overview

Journal Addict Sci Clin Pract

Publisher Biomed Central

Specialty Psychiatry

Date 2024 Sep 5

PMID 39238059

Authors

Tibor P Palfai

Lauren B Bernier

Maya Pl Kratzer

Kara M Magane

Sarah Fielman

John D Otis

Timothy C Heeren

Michael R Winter

Michael D Stein

Affiliations

Soon will be listed here.

Abstract

Background: Unhealthy alcohol use represents a significant risk for morbidity and mortality among people living with HIV (PLWH), in part through its impact on HIV management. Chronic pain, a common comorbidity, exacerbates suboptimal engagement in the HIV care continuum and has reciprocal detrimental effects on alcohol outcomes. There are no integrated, accessible approaches that address these comorbid conditions among PLWH to date. This paper describes a research study protocol of an integrated telehealth intervention to reduce unhealthy drinking and chronic pain among PLWH (Motivational and Cognitive-Behavioral Management for Alcohol and Pain [INTV]).

Methods: Two-hundred and fifty PLWH with unhealthy drinking and chronic pain will be recruited nationally via online advertisement. Informed consent and baseline assessments occur remotely, followed by 15 days of ecological momentary assessment to assess alcohol use, chronic pain, functioning, and mechanisms of behavior change. Next, participants will be randomized to either the INTV or Control (CTL) condition. Individuals in both conditions will meet with a health counselor through videoconferencing following randomization, and those in the INTV condition will receive 6 additional sessions. At 3- and 6-months post-baseline, participants will complete outcome assessments. It is hypothesized that the INTV condition will result in reduced unhealthy alcohol use and pain ratings compared to the CTL condition.

Conclusion: This protocol paper describes a randomized controlled trial which tests the efficacy of a novel, integrated telehealth approach to reduce unhealthy alcohol use and chronic pain for PLWH, two common comorbid conditions that influence the HIV treatment cascade.

Clinicaltrials:

Gov Identifier: NCT05503173.

Citing Articles

Recent advances in the treatment of chronic pain and substance use disorders.

Edwards K, Buonora M, Merlin J, Liebschutz J Curr Opin Psychol. 2024; 62:101977.

PMID: 39705790 PMC: 11867877. DOI: 10.1016/j.copsyc.2024.101977.

References

King V, Stoller K, Kidorf M, Kindbom K, Hursh S, Brady T . Assessing the effectiveness of an Internet-based videoconferencing platform for delivering intensified substance abuse counseling. J Subst Abuse Treat. 2008; 36(3):331-8. DOI: 10.1016/j.jsat.2008.06.011. View

Carpenter R, Nance M, Frumkin M, Boissoneault J, Ellingson J . Use and co-use of alcohol and cannabis following physical pain in the daily life of community adults engaged in regular substance use. Psychol Addict Behav. 2024; 38(7):747-758. PMC: 11324861. DOI: 10.1037/adb0000992. View

Armstrong M, LaPlante A, Altice F, Copenhaver M, Molina P . Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders. AIDS Res Treat. 2015; 2015:879052. PMC: 4678056. DOI: 10.1155/2015/879052. View

Russell D, Peplau L, Cutrona C . The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980; 39(3):472-80. DOI: 10.1037//0022-3514.39.3.472. View

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

Kuerbis A, Reid M, Lake J, Glasner-Edwards S, Jenkins J, Liao D . Daily factors driving daily substance use and chronic pain among older adults with HIV: An exploratory study using ecological momentary assessment. Alcohol. 2018; 77:31-39. PMC: 6456439. DOI: 10.1016/j.alcohol.2018.10.003. View

Shuper P, Joharchi N, Irving H, Rehm J . Alcohol as a correlate of unprotected sexual behavior among people living with HIV/AIDS: review and meta-analysis. AIDS Behav. 2009; 13(6):1021-36. DOI: 10.1007/s10461-009-9589-z. View

10.

Parisi C, Gracy H, Bush N, Cook R, Wang Y, Chichetto N . Does treating pain with alcohol affect drinking reduction among women with HIV enrolled in a clinical trial of naltrexone?. Alcohol Clin Exp Res (Hoboken). 2023; 47(10):1917-1925. PMC: 10662960. DOI: 10.1111/acer.15165. View

11.

Simons J, Gaher R, Oliver M, Bush J, Palmer M . An experience sampling study of associations between affect and alcohol use and problems among college students. J Stud Alcohol. 2005; 66(4):459-69. DOI: 10.15288/jsa.2005.66.459. View

12.

Jett J, Beck R, Tyutyunnyk D, Sanchez J, Lopez-Cruzan M, Ginsburg B . Validation of the quantification of phosphatidylethanol 16:0/18:1 concentrations in TASSO-M20 devices. Alcohol Clin Exp Res (Hoboken). 2023; 47(4):748-755. PMC: 10149590. DOI: 10.1111/acer.15024. View

13.

Williams L, Garcia-Gonzalez A, Mendoza T, Haq S, Cleeland C . Concept domain validation and item generation for the Treatment-Induced Neuropathy Assessment Scale (TNAS). Support Care Cancer. 2018; 27(3):1021-1028. DOI: 10.1007/s00520-018-4391-y. View

14.

Bush K, Kivlahan D, McDonell M, Fihn S, Bradley K . The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998; 158(16):1789-95. DOI: 10.1001/archinte.158.16.1789. View

15.

Fritz M, MacKinnon D . Required sample size to detect the mediated effect. Psychol Sci. 2007; 18(3):233-9. PMC: 2843527. DOI: 10.1111/j.1467-9280.2007.01882.x. View

16.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

17.

Hahn J, Emenyonu N, Fatch R, Muyindike W, Kekiibina A, Carrico A . Declining and rebounding unhealthy alcohol consumption during the first year of HIV care in rural Uganda, using phosphatidylethanol to augment self-report. Addiction. 2015; 111(2):272-9. PMC: 4715487. DOI: 10.1111/add.13173. View

18.

Hahn J, Murnane P, Vittinghoff E, Muyindike W, Emenyonu N, Fatch R . Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta-analysis. Alcohol Clin Exp Res. 2021; 45(6):1166-1187. PMC: 8254773. DOI: 10.1111/acer.14611. View

19.

Sun-Suslow N, Campbell L, Tang B, Fisher A, Lee E, Paolillo E . Use of digital health technologies to examine subjective and objective sleep with next-day cognition and daily indicators of health in persons with and without HIV. J Behav Med. 2021; 45(1):62-75. PMC: 8818628. DOI: 10.1007/s10865-021-00233-x. View

20.

Zale E, Maisto S, Ditre J . Interrelations between pain and alcohol: An integrative review. Clin Psychol Rev. 2015; 37:57-71. PMC: 4385458. DOI: 10.1016/j.cpr.2015.02.005. View