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Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain.
Garland, Eric L; Gullapalli, Bhanu T; Prince, Kort C; Hanley, Adam W; Sanyer, Mathias; Tuomenoksa, Mark; Rahman, Tauhidur.
Affiliation
  • Garland EL; University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA.
  • Gullapalli BT; Salt Lake VA Medical Center, Salt Lake City, USA.
  • Prince KC; University of California-San Diego, San Diego, USA.
  • Hanley AW; University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA.
  • Sanyer M; University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA.
  • Tuomenoksa M; Utah State University, Logan, USA.
  • Rahman T; Illumivu, Asheville, NC USA.
Mindfulness (N Y) ; : 1-17, 2023 May 24.
Article in En | MEDLINE | ID: mdl-37362184
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).
Key words

Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_mente_y_cuerpo / Meditacion Type of study: Clinical_trials / Prognostic_studies Language: En Journal: Mindfulness (N Y) Year: 2023 Type: Article

Full text: 1 Database: MEDLINE Therapeutic Methods and Therapies TCIM: Terapias_mente_y_cuerpo / Meditacion Type of study: Clinical_trials / Prognostic_studies Language: En Journal: Mindfulness (N Y) Year: 2023 Type: Article