Integrating Pain-CBT Into an mHealth Analgesic Support Intervention for Patients With Chronic Pain From Advanced Cancers
Summary
Smartphone Technology to Alleviate Malignant Pain (STAMP) + Cognitive Behavioral Therapy for Pain (STAMP+CBT) The purpose of the study is to develop and refine the mHealth pain-CBT app intervention and carry out a randomized pilot to test the novel mHealth (Mobile health technology) intervention, which harmonizes psychological and pharmacological support for advanced cancer pain. The name of the study smartphone application involved in this study is: -STAMP+CBT
Detailed description
The purpose of the study is to make sure the app is usable and helpful for participants with cancer and to get feedback about participants experiences after using the app for four weeks. Outcomes related to pain, quality of life, and healthcare utilization will also be assessed. The cancer pain education packet and pain and medication monitoring survey are standard care. The app is intended to improve self-management of cancer-related pain. The study will begin with Cohort A, followed by Cohort B. These two cohorts are to refine the STAMP+CBT intervention. Then a randomized pilot will be performed, and participants will be randomized into one of two study groups for the pilot: Cohort C: STAMP+CBT versus Cohort D: Digital Cancer Pain Education Packet + Usual Care. Randomization means a participant is placed into a study group by chance. It is expected that about 60 people will take part in this research study. The National Institutes of Health, National Cancer Institute (NIH-NCI), is funding this research study.
Arms & interventions
- BehavioralSTAMP + CBT
A mobile health, smartphone application that provides tailored multi-media, cancer pain psycho-education and pain management coping skills using algorithm-based technology to provide in the moment symptom monitoring and feedback.
- BehavioralDigital Cancer Pain Education Packet
Packet including Articles from the Association for Clinical Oncology and the National Cancer Institute and the pain and medication monitoring form.
Outcome measures
Primary
Overall intervention adherence rate (Cohort C)
\>70% of subjects complete any activity on the STAMP+CBT application at least 50% of days on study (4-week study period). The app will be considered feasible if this benchmark is achieved.
Time frame: Up to 4 weeks
Overall intervention adherence rate (Cohort D)
Defined as completion of the 14- and 28-days surveys, which assesses completion of the pain and medication monitoring reports by participants in the control group.
Time frame: Up to 4 weeks
Proportion of participants who rate app acceptability at least 4/5 on the Acceptability E-Scale (Cohort C)
Acceptability of the intervention is defined as \> 80% of the participants rate the application as satisfactory and useful with a mean 4 or higher score out of 5 on the Acceptability E-Scale (Tariman 2011). The Acceptability E-Scale a 7-item measure with answer ranging from 1 "Very Difficulty/Difficult to understand/Not at all/Very unacceptable/Very dissatisfied/Not useful/Very unlikely" to 5 "Very Easy/Easy to understand/Very much/ Very acceptable/Very satisfied/Very useful/Very likely" and with a total scores range of 7 to 35 with a higher score representing greater participant acceptability. Subjects will be assigned surveys at baseline, 4 weeks, and 6 weeks. Participants will rate the app on the following 5 domains: understandability, enjoyability, ease of use, time required to use the app, and overall satisfaction. Ratings lower than 4/5 will lead to refinements.
Time frame: Up to 6 weeks
Proportion of participants who rate educational packet acceptability at least 4/5 on the Acceptability E-Scale (Cohort D)
Acceptability of the intervention is defined as \> 80% of the participants rate the application as satisfactory and useful with a mean 4 or higher score out of 5 on the Acceptability E-Scale (Tariman 2011). The Acceptability E-Scale a 7-item measure with answer ranging from 1 "Very Difficulty/Difficult to understand/Not at all/Very unacceptable/Very dissatisfied/Not useful/Very unlikely" to 5 "Very Easy/Easy to understand/Very much/ Very acceptable/Very satisfied/Very useful/Very likely" and with a total scores range of 7 to 35 with a higher score representing greater participant acceptability. Subjects will be assigned surveys at baseline, 4 weeks, and 6 weeks. Participants will rate the app on the following 5 domains: understandability, enjoyability, ease of use, time required to use the app, and overall satisfaction. Ratings lower than 4/5 will lead to refinements.
Time frame: Up to 6 weeks
Secondary
Number of Enrolled Participants who Consented and Completed the Study (Cohort C)
Time frame: 18 months
Number of Enrolled Participants who Consented and Completed the Study (Cohort D)
Time frame: 18 months
Study Retention (Cohort C)
Time frame: 18 months
Study Retention (Cohort D)
Time frame: 18 months
Median assessment score on the system usability scale at 4 weeks (Cohort C)
Time frame: Up to 6 weeks
Median assessment score on the system usability scale at 4 weeks (Cohort D)
Time frame: Up to 6 weeks
Change in Brief Pain Inventory (BPI) Pain Interference Score from Baseline to 4 and 6 Weeks (Cohort C)
Time frame: Up to 6 weeks
Change in BPI Pain Interference Score from Baseline to 4 and 6 Weeks (Cohort D)
Time frame: Up to 6 weeks
Change in BPI Pain Intensity Score from Baseline to 4 and 6 Weeks (Cohort C)
Time frame: Up to 6 weeks
Change in BPI Pain Intensity Score from Baseline to 4 and 6 Weeks (Cohort D)
Time frame: Up to 6 weeks
Eligibility criteria
Study locations (1)
Dana Farber Cancer Institute
Boston, Massachusetts, 02215