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

Jessica S Merlin; Andrew O Westfall; Dustin Long; Susan Davies; Michael Saag; William Demonte; Sarah Young; Robert D Kerns; Matthew J Bair; Stefan Kertesz; Janet M Turan; Meredith Kilgore; Olivio J Clay; Joanna Starrels; Dorothy Pekmezi; Mallory O Johnson

doi:10.1007/s10461-018-2028-2

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

AIDS Behav. 2018 Aug;22(8):2733-2742. doi: 10.1007/s10461-018-2028-2.

Authors

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.

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.

Publication types

Randomized Controlled Trial

MeSH terms

Chronic Pain / epidemiology
Chronic Pain / therapy*
Cognitive Behavioral Therapy / methods*
Comorbidity
Feasibility Studies
Female
HIV Infections / epidemiology*
Humans
Male
Middle Aged
Pain Management*
Patient Acceptance of Health Care*
Pilot Projects
Self-Management*
Surveys and Questionnaires
Treatment Outcome

Abstract

Publication types

MeSH terms

Grants and funding