Telehealth for Pain and Unhealthy Drinking Among PLWH

Not Applicable

Recruiting

Brief Summary: This randomized controlled trial is a between-groups design to compare the Motivational and Cognitive Behavioral Management for Alcohol and Pain (MCBMAP) Intervention to a Brief Advice and Information Control condition.

Two-hundred and fifty participants who have HIV with moderate or greater chronic pain will be randomized for the trial. Recruitment will take place through digital media. A unique feature of this intervention trial is that most of the procedures will be conducted remotely which will minimize barriers of transportation and time for participants. Consent and baseline assessment will be completed remotely. Following baseline assessment, participants will complete two weeks of ecological momentary assessment (EMA) to assess alcohol use, chronic pain, physical function and mechanisms of behavior change for alcohol and pain management. Following the two-week phase, participants will be randomly assigned to either the intervention or control condition and meet the interventionist through videoconferencing. Participants will complete outcome assessment measures at 3- and 6-months post-baseline. Following the 3-month outcome assessment, participants will complete another two weeks of EMA.

Recruitment & Eligibility

Inclusion Criteria

Able to confirm HIV diagnosis, via visual evidence of antiretroviral (ART) medication bottle or medical record presented to study staff over Zoom.
Engaged in unhealthy drinking, defined as:
>7 drinks for women / > 14 drinks for men per week.
OR ≥ 3 drinks for women / ≥4 drinks for men on one occasion in the past month.
Experiencing moderate or greater chronic pain (4 or greater on the numerical pain rating scale) for at least 3 months.
Own a smart phone.
Lives in the USA.
Has a US mailing address.

Exclusion Criteria

History of bipolar, schizoaffective disorder or schizophrenia per self report.
Unstable dose of psychoactive medication for pain or alcohol/substance use [i.e., if on medication, participant has not been on same dose for least 2 months]
History of withdrawal-related seizures or delirium tremens
Current non-pharmacological treatment for alcohol use disorder or chronic pain
Acute life-threatening illness that requires treatment or intend to have surgery for a pain-related condition in the next 6-months.
Current cancer-related pain
Unable to provide one or more individuals for follow-up contact
Individual who is unwilling to provide their sex at birth
Limited or non-readers

Arm && Interventions

Group	Intervention	Description
Motivational and Cognitive-Behavioral Management for Alcohol and Pain Intervention (MCBMAP)	MCBMAP	Participants randomized to this arm will receive MCBMAP which utilizes a self-regulation framework to integrate evidence-based approaches for chronic pain and unhealthy drinking.
Brief Advice and Information	Brief Advice and Information	Participants randomized to this arm will be provided treatment as usual for their conditions.

Primary Outcome Measures

Name	Time	Method
Number of heavy episodic drinking days the past month at 6 months	6 months	Assessed by the Timeline Follow Back (TLFB-30) which is a is a calendar that allows an assessor to obtain an estimate of an individual's daily drinking habits over a 30-day time period.
Number of alcoholic drinks consumed per week at 6 months	6 months	Assessed by the Timeline Follow Back (TLFB-30) which is a is a calendar that allows an assessor to obtain an estimate of an individual's daily drinking habits over a 30-day time period.
Rating of pain severity and interference at 6 months	6 months	Assessed by the PEG Scale Assessing Pain Intensity and Interference (PEG) which is a 3-item scale measuring pain intensity, emotional function, and physical function over the past week.

Secondary Outcome Measures

Name	Time	Method
Rating of pain interference at 6 months	6 months	Assessed by the Brief Pain Inventory (BPI) which a 9-item self-report questionnaire in which participants rate the severity of pain and the degree of pain interference with various dimensions of feeling and function. Related pain is rated on a 0-10 scale and scored as Worst Pain Score: 1 - 4 = Mild Pain. Worst Pain Score: 5 - 6 = Moderate Pain. Worst Pain Score: 7 - 10 = Severe Pain.
Rating of pain severity at 6 months	6 months	Assessed by the Brief Pain Inventory (BPI) which a 9-item self-report questionnaire in which participants rate the severity of pain and the degree of pain interference with various dimensions of feeling and function. Related pain is rated on a 0-10 scale and scored as Worst Pain Score: 1 - 4 = Mild Pain. Worst Pain Score: 5 - 6 = Moderate Pain. Worst Pain Score: 7 - 10 = Severe Pain.

Locations (1): Charles River Campus, Boston University, Psychology Department- remote study
🇺🇸
Boston, Massachusetts, United States