Postoperative Telehealth Mindfulness Intervention to Improve Pain-related Outcomes and Reduce Opioid Use After Lumbar Spine Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chronic Low-back Pain
- Sponsor
- Vanderbilt University Medical Center
- Enrollment
- 10
- Locations
- 1
- Primary Endpoint
- Acceptability - Satisfaction With Intervention
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Lumbar spine pain is the leading cause of years lived with a disability and affects over 50 million individuals in the United States. Rates of spine surgeries performed to address degenerative spine conditions have increased markedly. A subset of patients experience poor pain, functional, or quality of life outcomes after surgery.
This study will adapt and evaluate the feasibility and potential benefits of both a one-on-one and a group-delivered, face-to-face telehealth, mindfulness intervention for patients recovering from lumbar spine surgery. The goals of the intervention are to improve short and long-term pain management, reduce the need for long-term pain medications, and improve physical and psychological well-being after surgery. The study will result in a refined intervention manual based on feasibility, participant exit interviews and satisfaction surveys which will be piloted in a future randomized controlled trial.
Detailed Description
We will conduct a two-arm, nonrandomized, mixed-methods trial to refine a telehealth mindfulness-based intervention (MBI) for patients recovering from spine surgery. The procedures will be as follows: 1. Recruit, consent and enroll up to 26 patients over a period of 8 months who are planning to have their first lumbar spine surgery for a degenerative spine condition at the Vanderbilt Comprehensive Spine Center. Recruitment will occur at a routine preoperative clinic visit or over the phone, with the spine surgeon's permission to approach the patient. 2. Two weeks after enrolled patients complete surgery, they will meet with an interventionist for eight, weekly one-on-one or group-delivered telehealth MBI sessions over a Zoom online telehealth platform. Sessions will be 75 minutes long (90 minutes for the first session). Sessions will be audio recorded and the interventionists will be supervised weekly. 3. Participants will complete self-report assessments prior to surgery, two weeks after surgery (pre-intervention) and three months after surgery (post-intervention). 4. After completing the intervention, participants will complete an intervention satisfaction survey and an audio-recorded 30-minute semi-structured interview over the phone to provide feedback regarding their experience with the intervention components and relevance to their postoperative recovery. 5. We will code and analyze interview data continuously (every 2-4 interviews) until we reach data saturation and then integrate results from interviews and self-report surveys to determine relevant intervention adaptations, constructing a refined intervention protocol for pilot testing in a randomized controlled trial. We anticipate needing approximately 13-20 participants to complete interviews to reach data saturation (i.e. no new, relevant information obtained from interviews).
Investigators
Carrie Brintz
Assistant Professor
Vanderbilt University Medical Center
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Acceptability - Satisfaction With Intervention
Time Frame: 3 months following lumbar spine surgery
Nine items assessing satisfaction with the postsurgical telehealth mindfulness intervention (sum of item scores; higher scores indicate higher satisfaction; scores can range from 7 to 55)
Feasibility - Session Attendance
Time Frame: 3 months following lumbar spine surgery
Percent of sessions attended out of 8
Feasibility - Study Retention
Time Frame: 3 months following lumbar spine surgery
Percentage of participants enrolled who complete the study
Secondary Outcomes
- Depression Short Form 4a(3 months postoperative)
- Pain Self-efficacy Questionnaire(3 months postoperative)
- Pain Bothersomeness(3 months postoperative)
- Perceived Stress Scale - 4(3 months postoperative)
- Five Facet Mindfulness Questionnaire - 15(3 months postoperative)
- Back and Leg Pain Intensity(3 months postoperative)
- Pain Interference Short-form 4a(3 months postoperative)
- Overall Pain Intensity(3 months postoperative)
- Self-reported Opioid Medication Use(3 months postoperative)
- Anxiety Short Form 4a(3 months postoperative)
- Tampa Scale for Kinesiophobia -13(3 months postoperative)
- Oswestry Disability Index(3 months postoperative)
- Pain Catastrophizing Scale(3 months postoperative)