Equipping Patients Using Interventions for Pain and Depression (EQUIPD)
Equipping Patients Using Interventions for Pain and Depression (EQUIPD) - Phase 2
This project is part of the NIH Helping to End Addiction Long-term (HEAL) initiative (https://heal.nih.gov/). This randomized controlled trial (RCT) is phase 2 of a two-phase, 5-year project with the overarching goal of testing a decision aid (DA)/coaching intervention, tailored to Black patients with comorbid chronic pain and depression, to encourage use of and adherence to nonpharmacological pain treatments (NPTs).
This 2-arm trial will randomize 304 patients with comorbid chronic musculoskeletal pain and depression in primary care from an urban safety-net health system (Eskenazi). After the baseline assessment, patients randomized to the intervention will be asked to participate in 4 coaching sessions over approximately 12 weeks. Sessions will use Motivational Interviewing principles to foster openness to NPTs and self-efficacy by helping patients identify their goals and priorities, understand their NPT options, prepare them to discuss and choose options with their primary care providers (PCPs), and reinforce these choices to foster maintenance of these changes. DA contents will be integrated into these sessions, which will facilitate discussion of these options with their PCP. The first 3 sessions take place prior to the patient's next scheduled PCP visit; the final session occurs after this visit. Assessments will be conducted at baseline, 3 months (i.e., after completing the final coaching session), and 6 months.
Patients randomized to the wait-list control group will receive usual care (in addition to study assessments at baseline, 3 months, and 6 months). After completing the final assessment, they will then be given the DA and offered a 20-minute coaching session to walk them through it.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Jennifer Garabrant
- Phone Number: 317-278-2510
- Email: jwilkers@iu.edu
Study Contact Backup
- Name: Research Specialist
- Phone Number: 317-274-9402
- Email: equipd@regenstrief.org
Study Locations
-
-
Indiana
-
Indianapolis, Indiana, United States, 46254
- Recruiting
- Eskenazi Health Primary Care
-
Contact:
- Research Specialist
- Phone Number: 317-274-9402
- Email: equipd@regenstrief.org
-
Principal Investigator:
- Adam T Hirsh, PhD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Eligible patients must
- have musculoskeletal pain in the low back, cervical spine, or extremities (hip, knee, shoulder) for ≥3 months,
- have at least moderate pain intensity and interference with function, defined by a score ≥4 (possible range: 0-10) on the Pain, Enjoyment of Life and General Activity scale (PEG), a 3-item measure of pain intensity, interference with enjoyment of life, and interference with general activity,
- have at least mild depression, defined as PHQ-8 score ≥5,
- identify as Black or African American,
- have consistent access to a telephone,
- indicate openness to new pain treatments, and
- have a scheduled appointment with their PCP in the next approximate 2-4 months or be willing to schedule one
Exclusion Criteria:
Patients are excluded:
- if previously participated in Dr. Matthias' past pilot study (IRB #12885), the pilot RCT for this project (IRB #16571), or are participating as a Patient Engagement Panel member for this project (Aim 1.1),
- if the eligibility screener or medical records indicate severe medical conditions likely precluding participation (e.g. stroke in the last 6 months, hospitalized with congestive heart failure or a heart attack in the last 6 months, cancer other than skin cancer and receiving active treatment), or
- if the eligibility screener or medical records reveal (1) active suicidal ideation, or (2) severe hearing/speech or cognitive impairment.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Control
Wait-list control group
|
|
|
Experimental: Coaching and Decision Aid
Intervention group (Individual coaching sessions and Decision Aid)
|
Four (4) coaching sessions over approximately 12 weeks with integration of Decision Aid contents
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from Baseline Brief Pain Inventory (BPI) Interference Scale at 3 months
Time Frame: 3 months
|
The pain interference score averages seven ratings, 0 (does not interfere) to 10 (completely interferes).
|
3 months
|
|
Change from Baseline Brief Pain Inventory (BPI) Interference Scale at 6 months
Time Frame: 6 months
|
The pain interference score averages seven ratings, 0 (does not interfere) to 10 (completely interferes).
|
6 months
|
|
Change from Baseline Patient Health Questionnaire (PHQ)-8 at 3 months
Time Frame: 3 months
|
The Patient Health Questionnaire (PHQ)-8 is a widely-used, validated 8-item measure of depression severity that uses a 4-point Likert scale ranging from 0 (not at all) to 3 (nearly every day).
|
3 months
|
|
Change from Baseline Patient Health Questionnaire (PHQ)-8 at 6 months
Time Frame: 6 months
|
The Patient Health Questionnaire (PHQ)-8 is a widely-used, validated 8-item measure of depression severity that uses a 4-point Likert scale ranging from 0 (not at all) to 3 (nearly every day).
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from Baseline Use of Nonpharmacological and Self-Care Approaches (NSCAP) at 3 months
Time Frame: 3 months
|
The NSCAP asks about 9 nonpharmacological treatment (NPT) modalities and assesses details of use such as frequency, location/source of service, and patients' judgments of effectiveness.
Space is also provided for other NPTs that are used but not listed.
The number of modalities for which patients answer "yes" will be summed for analyses.
|
3 months
|
|
Change from Baseline Use of Nonpharmacological and Self-Care Approaches (NSCAP) at 6 months
Time Frame: 6 months
|
The NSCAP asks about 9 nonpharmacological treatment (NPT) modalities and assesses details of use such as frequency, location/source of service, and patients' judgments of effectiveness.
Space is also provided for other NPTs that are used but not listed.
The number of modalities for which patients answer "yes" will be summed for analyses.
|
6 months
|
|
Change from Baseline Generalized Anxiety Disorder (GAD)-7 at 3 months
Time Frame: 3 months
|
Anxiety will be measured with the 7 item Generalized Anxiety Disorder (GAD)-7 that uses a 4-point Likert scale ranging from 0 (not at all) to 3 (nearly every day).
|
3 months
|
|
Change from Baseline Generalized Anxiety Disorder (GAD)-7 at 6 months
Time Frame: 6 months
|
Anxiety will be measured with the 7 item Generalized Anxiety Disorder (GAD)-7 that uses a 4-point Likert scale ranging from 0 (not at all) to 3 (nearly every day).
|
6 months
|
|
Change from Baseline Pain Catastrophizing Scale at 3 months
Time Frame: 3 months
|
The Pain Catastrophizing Scale is a 13-item scale that assesses catastrophizing-a cognitive-emotional factor that predicts poor treatment response.
The scale uses a 5-point Likert scale ranging from 0 (not at all) to 4 (all the time).
|
3 months
|
|
Change from Baseline Pain Catastrophizing Scale at 6 months
Time Frame: 6 months
|
The Pain Catastrophizing Scale is a 13-item scale that assesses catastrophizing-a cognitive-emotional factor that predicts poor treatment response.
The scale uses a 5-point Likert scale ranging from 0 (not at all) to 4 (all the time).
|
6 months
|
|
Change from Baseline Altarum Consumer Engagement (ACE) Measure at 3 months
Time Frame: 3 months
|
Patient engagement will be measured with the 12-item Altarum Consumer Engagement (ACE) Measure, which has 3 subscales: 1) commitment to manage one's health, 2) informed choice, and 3) confidence to participate in treatment decisions.
Items are assessed on a 5-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree).
|
3 months
|
|
Change from Baseline Altarum Consumer Engagement (ACE) Measure at 6 months
Time Frame: 6 months
|
Patient engagement will be measured with the 12-item Altarum Consumer Engagement (ACE) Measure, which has 3 subscales: 1) commitment to manage one's health, 2) informed choice, and 3) confidence to participate in treatment decisions.
Items are assessed on a 5-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree).
|
6 months
|
|
Change from Baseline Decisional Conflict Scale (DCS) at 3 months
Time Frame: 3 months
|
Decisional conflict will be measured with the 16-item Decisional Conflict Scale that measures personal perceptions of a) uncertainty in choosing options, b) modifiable factors contributing to uncertainty, and c) effective decision making on a 5-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree).
|
3 months
|
|
Change from Baseline Decisional Conflict Scale (DCS) at 6 months
Time Frame: 6 months
|
Decisional conflict will be measured with the 16-item Decisional Conflict Scale that measures personal perceptions of a) uncertainty in choosing options, b) modifiable factors contributing to uncertainty, and c) effective decision making on a 5-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree).
|
6 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from Baseline Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) at 3 months
Time Frame: 3 months
|
Communication self-efficacy will be measured with this 5-item scale that measures patients' self-efficacy in obtaining medical information and getting their most important health concern discussed in a clinic visit.
The scale uses ratings from 0 (not at all confident) to 10 (extremely confident).
|
3 months
|
|
Change from Baseline Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI-5) at 6 months
Time Frame: 6 months
|
Communication self-efficacy will be measured with this 5-item scale that measures patients' self-efficacy in obtaining medical information and getting their most important health concern discussed in a clinic visit.
The scale uses ratings from 0 (not at all confident) to 10 (extremely confident).
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Adam T Hirsh, PhD, Indiana University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 22412
- 4R33NR020845-02 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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