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Integrated Psychosocial Group Treatment (IPGT): A Randomized Pilot Trial of a Harm Reduction and Preventative Approach for Chronic Pain Patients at Risk for Opioid Misue

Hruschak, Valerie (2019) Integrated Psychosocial Group Treatment (IPGT): A Randomized Pilot Trial of a Harm Reduction and Preventative Approach for Chronic Pain Patients at Risk for Opioid Misue. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

The United States is experiencing an interrelated public health crisis, involving the management of chronic pain and the risks associated with opioid misuse. A fundamental challenge for healthcare is to achieve a balance between decreasing the misuse of opioids and associated harms while optimizing pain care. This dissertation conducted a pilot randomized control trial (RCT) for an integrated psychosocial group treatment (IPGT) model for patients with chronic pain who are at risk for opioid misuse. A primary aim of this study was to examine the feasibility and acceptability of IPGT for chronic pain patients at risk for opioid misuse. This dissertation also investigated the preliminary efficacy of IPGT in chronic pain patients at risk for opioid misuse. Recruitment occurred from June 2018 until November 2018. All intervention components were delivered to 87% (n=13) of the participants, successfully achieving the goal of 75% or higher. IPGT recipients reported a high level of satisfaction with the intervention. Regarding preliminary efficacy, results showed that the IPGT intervention group made nonsignificant improvements in pain severity compared to the TAU control group (β =0.22, 95% CI= -0.24, 0.66, p = 0.35). However, we observed significant treatment by time interactions on the outcome of pain interference (β =3.32, 95% CI= 0.01, 6.65, p = 0.05) and pain catastrophizing (β =2.74, 95% CI= 0.49, 4.99, p = 0.02). We detected no significant differences in opioid misuse between participants who received the IPGT intervention and those patients in the control group (AOR= 069, 95% CI=-0.26, 1.64, p=0.16). This dissertation provides initial support for IPGT being acceptable and feasible for delivery in chronic pain patients at risk for opioid misuse in which preliminary efficacy was demonstrated in both pain interference and pain catastrophizing. To better establish these findings, future studies should expand on these data by further investigating this intervention within a fully powered clinical trial framework. The preliminary findings of this dissertation support the next steps of the development of a novel treatment model (IPGT) which includes the social work lens to address chronic pain patients at risk for opioid misuse while providing greater insight into strategies to address this public health crisis.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Hruschak, Valerievalerie.hruschak@gmail.comVJH6@Pitt.edu0000-0003-0791-6970
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCochran, Geraldjerry.cochran@hsc.utah.edu
Committee CoChairRosen, Danieldannyrosen@pitt.edu
Committee MemberEack, Shaunsme12@pitt.edu
Committee MemberWasan, Ajaywasanad@upmc.edu
Date: 22 August 2019
Date Type: Publication
Defense Date: 10 July 2019
Approval Date: 22 August 2019
Submission Date: 22 August 2019
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 195
Institution: University of Pittsburgh
Schools and Programs: School of Social Work > Social Work
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: chronic pain, opioid misuse, harm reduction, clinical trial, social work
Date Deposited: 22 Aug 2019 16:02
Last Modified: 22 Aug 2019 16:02
URI: http://d-scholarship.pitt.edu/id/eprint/37403

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