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Combined Effectiveness of Opioid Medication and Behavioral Interventions on Clinical Pain

Principal Investigator: Karen O. Anderson, Ph.D.

This study will test the generalizability of our laboratory findings concerning the effects of morphine and behavioral tasks on pain perception. Our previous studies found that alterations in mood affected pain tolerance and alternations in attention in a distraction task affected pain ratings (Hodes et al., 1990; Zelman et al., 1991). In this study, hypotheses developed from laboratory studies will be tested in cancer patients who are taking opioid medications for pain control on a daily basis. This study will compare the relative effectiveness of three behavioral treatments (positive mood induction, relaxation, distraction) with one another and with a delayed treatment control condition.

Specific Goals

  • To evaluate the efficacy of behavioral interventions for pain control in cancer patients taking opioid medications for pain management
  • To compare the relative effectiveness of three behavioral treatments (positive mood induction, relaxation, distraction) with one another and with a delayed treatment control condition in cancer patients taking opioid medications for pain management

Methods

Patients who agree to participate in the study will be randomly assigned to one of four groups: (1) a wait list control group, (2) a distraction intervention, (3) a positive mood intervention and (4) a relaxation intervention. The patients in the three intervention groups will be given an audiotape containing the behavioral technique and will be asked to practice the technique five times a week for two weeks. The research nurse will telephone all patients enrolled in the study periodically after the first assessment (T1) to answer any questions. All of the patients will be asked to return to the clinic in two to three weeks (T2) for the assessment of pain intensity, pain interference, mood, symptoms and quality of life. In the event a patient is unable to return to the clinic the assessment will be done by telephone. Additional follow-up assessments will be conducted by telephone or clinic interviews at four to five (T3) and eight to nine weeks (T4) after study enrollment. The wait list control group will be presented with their intervention options (choice of behavioral audiotape) during the T3 interview.

Measures

The outcome measures include the Brief Pain Inventory (BPI), MD Anderson Symptom Inventory (MDASI), the Functional Assessment of Cancer Therapy (FACT-G), Outcome Expectancy and Self-Efficacy (OESE) and the Profile of Mood States (POMS).

For more information

Contact Margaret Harle, B.S.N., O.C.N., at mharle@mdanderson.org


© 2014 The University of Texas MD Anderson Cancer Center