A Randomized Pilot Trial of a Novel Behavioral Intervention for Chronic Pain Tailored to Individuals with HIV

Jessica S Merlin¹, Andrew O Westfall^{2

3}, Dustin Long^{2

3}, Susan Davies⁴, Michael Saag², William Demonte², Sarah Young^{2

5}, Robert D Kerns^{6

7}, Matthew J Bair^{8

9

10}, Stefan Kertesz^{11

12}, Janet M Turan¹³, Meredith Kilgore¹³, Olivio J Clay¹⁴, Joanna Starrels¹⁵, Dorothy Pekmezi⁴, Mallory O Johnson¹⁶

Affiliations

¹ Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, 230 McKee Place Suite 600, Pittsburgh, PA, 15213, USA. merlinjs@pitt.edu.
² Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
³ Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Department of Social Work, Binghamton University, Binghamton, NY, USA.
⁶ Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA.
⁷ Departments of Psychiatry, Neurology and Psychology, Yale University, New Haven, CT, USA.
⁸ VA HSR&D Center for Health Information and Communication, Indianapolis, USA.
⁹ Division of General Internal Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
¹⁰ Regenstrief Institute, Indianapolis, IN, USA.
¹¹ Birmingham VA Medical Center, Birmingham, AL, USA.
¹² Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
¹³ Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁴ Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁵ Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
¹⁶ Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. Mallory.johnson@ucsf.edu.

PMID: 29340913
PMCID: PMC6047927
DOI: 10.1007/s10461-018-2028-2

Randomized Controlled Trial

A Randomized Pilot Trial of a Novel Behavioral Intervention for Chronic Pain Tailored to Individuals with HIV

Jessica S Merlin et al. AIDS Behav. 2018 Aug.

. 2018 Aug;22(8):2733-2742.

doi: 10.1007/s10461-018-2028-2.

Authors

Affiliations

¹ Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, 230 McKee Place Suite 600, Pittsburgh, PA, 15213, USA. merlinjs@pitt.edu.
² Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
³ Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Department of Social Work, Binghamton University, Binghamton, NY, USA.
⁶ Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA.
⁷ Departments of Psychiatry, Neurology and Psychology, Yale University, New Haven, CT, USA.
⁸ VA HSR&D Center for Health Information and Communication, Indianapolis, USA.
⁹ Division of General Internal Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
¹⁰ Regenstrief Institute, Indianapolis, IN, USA.
¹¹ Birmingham VA Medical Center, Birmingham, AL, USA.
¹² Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
¹³ Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁴ Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁵ Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
¹⁶ Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. Mallory.johnson@ucsf.edu.

PMID: 29340913
PMCID: PMC6047927
DOI: 10.1007/s10461-018-2028-2

Abstract

Chronic pain is an important and understudied comorbidity in people living with HIV (PLWH). We conducted a pilot trial of Skills TO Manage Pain (STOMP), an innovative social cognitive theory-based pain self-management intervention tailored to PLWH, to assess feasibility, acceptability, and preliminary efficacy. Eligibility criteria included being HIV+, ≥ moderate pain for ≥ 3 months and a score of ≥ 4 on the three-item PEG pain severity and interference scale. Participants were randomized in a 1:1 fashion to STOMP or a usual care comparison. Among 22 participants randomized to STOMP, median session attendance was 9/12 (75%). Of 19 STOMP participants surveyed, 13 reported being "much better" overall since beginning treatment. Brief pain inventory-total scores decreased by 2 points in the intervention group and 0.9 in the control group (p = 0.11). STOMP is feasible, acceptable, and shows preliminary evidence of efficacy and promise for a full-scale trial.

Keywords: HIV; Pain; Self-management; Social cognitive theory.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest Dr. Kertesz reports ownership of stock in Merck and Abbot, amount to less than 3% of assets but no income, honoraria, grants, or other associations with any drug company. Dr. Starrels receives research support from the Opioid Post-marketing Requirement Consortium to conduct FDA-mandated observational research. The following authors declare no conflicts of interest: Dr. Merlin, Mr. Westfall, Drs. Long, Davies, Saag, Demonte, Young, Kerns, Bair, Turan, Kilgore, Clay, Pekmezi, and Johnson.

Figures

See this image and copyright information in PMC

References

1. Merlin JS, Westfall AO, Raper JL, Zinski A, Norton WE, Willig JH, et al. Chronic pain, psychiatric, and substance abuse comorbidities: implications for adherence to HIV care, ART, and virologic suppression; International workshop on HIV observational databases; Athens, Greece. March 2012.
1. Merlin JS, Cen L, Praestgaard A, Turner M, Obando A, Alpert C, et al. Pain and physical and psychological symptoms in ambulatory HIV patients in the current treatment era. J Pain Symptom Manag. 2012;43(3):638–45. - PMC - PubMed
1. Miaskowski C, Penko JM, Guzman D, Mattson JE, Bangsberg DR, Kushel MB. Occurrence and characteristics of chronic pain in a community-based cohort of indigent adults living with HIV infection. J Pain. 2011;12(9):1004–16. - PMC - PubMed
1. Jiao JM, So E, Jebakumar J, George MC, Simpson DM, Robinson-Papp J. Chronic pain disorders in HIV primary care: clinical characteristics and association with healthcare utilization. Pain. 2015 doi: 10.1097/j.pain.0000000000000462. - DOI - PubMed
1. Perry BA, Westfall AO, Molony E, Tucker R, Ritchie C, Saag MS, et al. Characteristics of an ambulatory palliative care clinic for HIV-infected patients. J Palliat Med. 2013;16(8):934–7. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

A Randomized Pilot Trial of a Novel Behavioral Intervention for Chronic Pain Tailored to Individuals with HIV

Affiliations

A Randomized Pilot Trial of a Novel Behavioral Intervention for Chronic Pain Tailored to Individuals with HIV

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical