Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain
- 24-05-2023
- ORIGINAL PAPER
Gepubliceerd in:
- 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).
- 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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