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24-05-2023 | ORIGINAL PAPER

Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain

Auteurs: Eric L. Garland, Bhanu T. Gullapalli, Kort C. Prince, Adam W. Hanley, Mathias Sanyer, Mark Tuomenoksa, Tauhidur Rahman

Gepubliceerd in: Mindfulness | Uitgave 6/2023

Abstract

Objective

The opioid crisis in the USA remains severe during the COVID-19 pandemic, which has reduced access to evidence-based interventions. This Stage 1 randomized controlled trial (RCT) assessed the preliminary efficacy of Zoom-based Mindfulness-Oriented Recovery Enhancement (MORE) plus Just-in-Time Adaptive Intervention (JITAI) prompts to practice mindfulness triggered by wearable sensors (MORE + JITAI).

Method

Opioid-treated chronic pain patients (n = 63) were randomized to MORE + JITAI or a Zoom-based supportive group (SG) psychotherapy control. Participants completed ecological momentary assessments (EMA) of craving and pain (co-primary outcomes), as well as positive affect, and stress at one random probe per day for 90 days. EMA probes were also triggered when a wearable sensor detected the presence of physiological stress, as indicated by changes in heart rate variability (HRV), at which time participants in MORE + JITAI were prompted by an app to engage in audio-guided mindfulness practice.

Results

EMA showed significantly greater reductions in craving, pain, and stress, and increased positive affect over time for participants in MORE + JITAI than for participants in SG. JITAI-initiated mindfulness practice was associated with significant improvements in these variables, as well as increases in HRV. Machine learning predicted JITAI-initiated mindfulness practice effectiveness with reasonable sensitivity and specificity.

Conclusions

In this pilot trial, MORE + JITAI demonstrated preliminary efficacy for reducing opioid craving and pain, two factors implicated in opioid misuse. MORE + JITAI is a promising intervention that warrants investigation in a fully powered RCT.

Preregistration

This study is registered on ClinicalTrials.gov (NCT04567043).

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Titel: Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain
Auteurs: Eric L. Garland
Bhanu T. Gullapalli
Kort C. Prince
Adam W. Hanley
Mathias Sanyer
Mark Tuomenoksa
Tauhidur Rahman
Publicatiedatum: 24-05-2023
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 6/2023
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-023-02137-0

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Abstract

Objective

Method

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