scholarly journals Acceptance and Commitment Therapy Delivered via a Mobile Phone Messaging Robot to Decrease Postoperative Opioid Use in Patients With Orthopedic Trauma: Randomized Controlled Trial

10.2196/17750 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e17750
Author(s):  
Chris A Anthony ◽  
Edward Octavio Rojas ◽  
Valerie Keffala ◽  
Natalie Ann Glass ◽  
Apurva S Shah ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Pain Intensity ◽  
Acceptance And Commitment Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Orthopedic Trauma ◽  
Opioid Use ◽  
Acceptance And Commitment ◽  
Patient Reported ◽  
The Mean

Background Acceptance and commitment therapy (ACT) is a pragmatic approach to help individuals decrease avoidable pain. Objective This study aims to evaluate the effects of ACT delivered via an automated mobile messaging robot on postoperative opioid use and patient-reported outcomes (PROs) in patients with orthopedic trauma who underwent operative intervention for their injuries. Methods Adult patients presenting to a level 1 trauma center who underwent operative fixation of a traumatic upper or lower extremity fracture and who used mobile phone text messaging were eligible for the study. Patients were randomized in a 1:1 ratio to either the intervention group, who received twice-daily mobile phone messages communicating an ACT-based intervention for the first 2 weeks after surgery, or the control group, who received no messages. Baseline PROs were completed. Two weeks after the operative intervention, follow-up was performed in the form of an opioid medication pill count and postoperative administration of PROs. The mean number of opioid tablets used by patients was calculated and compared between groups. The mean PRO scores were also compared between the groups. Results A total of 82 subjects were enrolled in the study. Of the 82 participants, 76 (38 ACT and 38 controls) completed the study. No differences between groups in demographic factors were identified. The intervention group used an average of 26.1 (SD 21.4) opioid tablets, whereas the control group used 41.1 (SD 22.0) tablets, resulting in 36.5% ([41.1-26.1]/41.1) less tablets used by subjects receiving the mobile phone–based ACT intervention (P=.004). The intervention group subjects reported a lower postoperative Patient-Reported Outcome Measure Information System Pain Intensity score (mean 45.9, SD 7.2) than control group subjects (mean 49.7, SD 8.8; P=.04). Conclusions In this study, the delivery of an ACT-based intervention via an automated mobile messaging robot in the acute postoperative period decreased opioid use in selected patients with orthopedic trauma. Participants receiving the ACT-based intervention also reported lower pain intensity after 2 weeks, although this may not represent a clinically important difference. Trial Registration ClinicalTrials.gov NCT03991546; https://clinicaltrials.gov/ct2/show/NCT03991546

scholarly journals Acceptance and Commitment Therapy Delivered via a Mobile Phone Messaging Robot to Decrease Postoperative Opioid Use in Patients With Orthopedic Trauma: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Chris A Anthony ◽  
Edward Octavio Rojas ◽  
Valerie Keffala ◽  
Natalie Ann Glass ◽  
Apurva S Shah ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Pain Intensity ◽  
Acceptance And Commitment Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Orthopedic Trauma ◽  
Opioid Use ◽  
Acceptance And Commitment ◽  
Patient Reported ◽  
The Mean

BACKGROUND Acceptance and commitment therapy (ACT) is a pragmatic approach to help individuals decrease avoidable pain. OBJECTIVE This study aims to evaluate the effects of ACT delivered via an automated mobile messaging robot on postoperative opioid use and patient-reported outcomes (PROs) in patients with orthopedic trauma who underwent operative intervention for their injuries. METHODS Adult patients presenting to a level 1 trauma center who underwent operative fixation of a traumatic upper or lower extremity fracture and who used mobile phone text messaging were eligible for the study. Patients were randomized in a 1:1 ratio to either the intervention group, who received twice-daily mobile phone messages communicating an ACT-based intervention for the first 2 weeks after surgery, or the control group, who received no messages. Baseline PROs were completed. Two weeks after the operative intervention, follow-up was performed in the form of an opioid medication pill count and postoperative administration of PROs. The mean number of opioid tablets used by patients was calculated and compared between groups. The mean PRO scores were also compared between the groups. RESULTS A total of 82 subjects were enrolled in the study. Of the 82 participants, 76 (38 ACT and 38 controls) completed the study. No differences between groups in demographic factors were identified. The intervention group used an average of 26.1 (SD 21.4) opioid tablets, whereas the control group used 41.1 (SD 22.0) tablets, resulting in 36.5% ([41.1-26.1]/41.1) less tablets used by subjects receiving the mobile phone–based ACT intervention (<i>P</i>=.004). The intervention group subjects reported a lower postoperative Patient-Reported Outcome Measure Information System Pain Intensity score (mean 45.9, SD 7.2) than control group subjects (mean 49.7, SD 8.8; <i>P</i>=.04). CONCLUSIONS In this study, the delivery of an ACT-based intervention via an automated mobile messaging robot in the acute postoperative period decreased opioid use in selected patients with orthopedic trauma. Participants receiving the ACT-based intervention also reported lower pain intensity after 2 weeks, although this may not represent a clinically important difference. CLINICALTRIAL ClinicalTrials.gov NCT03991546; https://clinicaltrials.gov/ct2/show/NCT03991546

Effect of an early mobilisation programme on pain intensity after laparoscopic surgery: a randomised clinical trial

2020 ◽  
pp. bmjspcare-2020-002618
Author(s):  
Azam Dehghani ◽  
Ali Hajibagheri ◽  
Ismail Azizi-Fini ◽  
Fatemeh Atoof ◽  
Noushin Mousavi
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Surgery ◽  
Pain Intensity ◽  
Repeated Measures ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Early Mobilisation ◽  
Repeated Measures Analysis ◽  
The Mean

BackgroundPain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.MethodsA randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient’s perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher’s exact tests and the repeated measures analysis.ResultsThe repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).ConclusionEarly mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.

scholarly journals Effectiveness of Acceptance and Commitment Therapy on Treatment Adherence in People with Non-Alcoholic Fatty Liver Disease

2021 ◽  
Author(s):  
Mohammad Oraki ◽  
Hossein Zare ◽  
Ali Hosseinzadeh Ghasemabad
Keyword(s):  
Fatty Liver ◽  
Treatment Adherence ◽  
Acceptance And Commitment Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Alcoholic Fatty Liver ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Post Test

Introduction: The present study was conducted with the aim of acceptance and commitment therapy (ACT) on treatment adherence in people with non-alcoholic fatty liver disease (NAFLD). Methods: This study was a quasi-experimental design with an experimental group and a control group with pre-test, post-test and two-month follow-up. This study was conducted in 2019 in Tehran in the statistical population of people with NAFLD diagnosis. In this study, 30 individuals with NAFLD were purposefully selected and they were randomly assigned to two groups and received a pre-test. Then, the experimental group underwent group intervention of acceptance and commitment therapy during two months of ten sessions while the control group had received the typical routine interventions from medical centers. The Morisky Medication Adherence Scale (Moriski et al., 2008) was conducted in the all of three stages of measurement. In order to analyze the data, repeated measures analysis of variance test with SPSS-16 software was used. Results: The trend of changes in the intervention group compared to the control group in the measurement stages in the treatment adherence to the treatment (F= 4.243, P=0.03) was significantly different (P <0.05) and about 15% of the differences observed in this variable is due to group membership (intervention). To compare these changes over time, Benfron's subtest was used. The difference between pre-test with post-test and follow-up were only significant in the intervention group (P <0.05). Conclusion: Acceptance and commitment-based therapy increases treatment adherence. Therefore, it is suggested that this method be used to increase treatment adherence in people with non-alcoholic fatty liver.

scholarly journals The Effect of Self-Management Educational Program on Pain Intensity in Elderly Patients with Knee Osteoarthritis: A Randomized Clinical Trial

2018 ◽  
Vol 6 (6) ◽  
pp. 1062-1066 ◽  
Author(s):  
Reza Ganji ◽  
Azadeh Pakniat ◽  
Mohammad Reza Armat ◽  
Mahbubeh Tabatabaeichehr ◽  
Hamed Mortazavi
Keyword(s):  
Elderly Patients ◽  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Educational Program ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Control Groups ◽  
The Mean ◽  
And Control

BACKGROUND: Osteoarthritis is one of the chronic diseases that greatly affect the health and life quality of individuals.AIM: This study aimed to determine the effect of self-management educational program on the pain intensity of the elderly patients with knee osteoarthritis.METHODS: In a randomised clinical trial, a total of 82 elderly patients with knee osteoarthritis were randomly divided into intervention and control groups. The intervention group received six sessions of self-management group education, while the control group received only the routine care during this period. In both groups, patients’ pain intensity, with a visual analogue scale (VAS), were assessed before, immediately after and eight weeks after the start of the study.RESULTS: The mean pain intensity scores of the intervention and control groups were not significantly different before the intervention (P = 0.9), but after the intervention, the mean pain intensity score in the intervention group (3.61 ± 2.36) was significantly lower than that of the control group (4.93 ± 2.00), (P < 0.0001).CONCLUSION: Implementation of a self-management program for the patients with knee osteoarthritis is useful in reducing their pain intensity and can be used as one of the effective methods for their empowerment.

scholarly journals Effect of Acceptance and Commitment Therapy on Sexual Desire in Women with Breast Cancer after Mastectomy

2019 ◽  
Vol 12 (4) ◽  
pp. 39-51
Author(s):  
Sheida Jabalameli ◽  
Leila Ghasemi
Keyword(s):  
Breast Cancer ◽  
Acceptance And Commitment Therapy ◽  
Sexual Desire ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Statistical Population ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Significant Difference ◽  
The Mean

Introduction: The effects of breast cancer and mastectomy on sexuality, an important aspect of personality, emphasize the need for psychological treatments. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy (ACT) on sexual desire in breast cancer patients after mastectomy. Methods: This was a semiexperimental study with an experimental and a control group with a pretest-posttest design. The statistical population included all women with breast cancer in the Isfahan province who had come to Alla charity center in 2017. A sample of 26 women with breast cancer was selected through available sampling and assigned randomly to two groups of 13 subjects each. The experimental group received ACT over 8 sessions and the control group remained on the waiting list until the end of the study. The measurement tool was the Hurlbert Index of Sexual Desire administered before and after the intervention. Data were analyzed with SPSS 16 using an analysis of covariance test. Results: There was a significant difference in the mean scores on sexual desire between the two groups (F = 7.99, p = 0.014). The mean score on sexual desire improved from 0.85 to 1.23 in the treatment group, but there was no change in the control group (1.17 in the pretest vs 1.16 in the posttest). In general, ACT was effective in improving sexual desire in patients (p < 0.05, effect size: 0.48). Conclusion: In general, according to the findings of this research, ACT seems to be effective in improving psychological problems in women with breast cancer.

The Effect of ACT on Self-Esteem and Self-efficacy of Women with Breast Cancer in Iran

2020 ◽  
Vol 16 (1) ◽  
pp. 74-80
Author(s):  
Masoumeh Daneshvar ◽  
Katayon Vakilian ◽  
Akbar Hedayati Zadeh-Emran ◽  
Ramezan Hassan Zadeh
Keyword(s):  
Breast Cancer ◽  
Self Efficacy ◽  
Intervention Group ◽  
Self Esteem ◽  
Control Group ◽  
Acceptance And Commitment ◽  
Before And After ◽  
Registration Number ◽  
The Mean ◽  
And Control

Background: Today, breast cancer is the second major cause of cancer deaths in women. Objective: The present study aimed to determine the effect of acceptance and commitment therapy (ACT) on self-esteem and self-efficacy of cancer adaptation behaviors in women. Methods: The present study was a randomized educational trial (IRCT Registration number: IRCT2016100430140N1) based on intervention and control groups including 30 patients with breast cancer who were referred to Cancer comprehensive center of Imam Khomeini Hospital in Sari 2017. The intervention group participated in ACT sessions for 8 weeks held as 8 sessions. In the control group, there was no intervention and only chemotherapy was carried out. Self-esteem and self-efficacy of cancer adaptation behaviors were assessed using Rosenberg Self-esteem Scale and Cancer Behavior Inventory before and after the intervention and one month later. Data analysis was tested by repeated measurement, ANOVA and Tukey post-hoc tests. Results: The mean of self-esteem before and after intervention and one month later was 13.46 ± 1.12, 16.86 ± 0.91, 15.86 ± 0.99 in ACT group, and 14 ± 1, 14.40 ± 0.98, 14.20 ± 1.08 in the control group, respectively (F(2,27)=11.90, P=0.001). The mean of self-efficacy of cancer adjustment behaviors before and after the intervention and one month later was 104.40 ± 20.19, 218.20 ± 15.32, 214.86 ± 16.97 in ACT group, and 96.86 ± 15.04, 97.06 ± 18.61, 94.53 ± 14.69 in the control group, respectively (F(2,27)=8.26, P=0.001). Conclusion: This counseling approach can be used as an easy, non-invasive and helpful method to increase self-esteem and self-efficacy among patients for adaptation to cancer.

scholarly journals Feasibility randomised controlled trial of a self-help acceptance and commitment therapy intervention for grief and psychological distress in carers of palliative care patients

2017 ◽  
Vol 25 (3) ◽  
pp. 322-339 ◽  
Author(s):  
Esther L Davis ◽  
Frank P Deane ◽  
Geoffrey CB Lyons ◽  
Gregory D Barclay ◽  
Joan Bourne ◽  
...  
Keyword(s):  
Palliative Care ◽  
Psychological Distress ◽  
Acceptance And Commitment Therapy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Treatment As Usual ◽  
Self Help ◽  
Commitment Therapy ◽  
Acceptance And Commitment

We tested the feasibility and preliminary effectiveness of an acceptance and commitment therapy self-help intervention for grief and psychological distress in carers of patients in palliative care. Carers were randomised to the control group, which received treatment as usual, or the intervention group, which received treatment as usual plus an acceptance and commitment therapy–based self-help booklet and telephone support call. Questionnaires were completed at baseline, 1-month post-allocation and 6 months post-loss. Results indicated that the intervention was generally feasible and viewed as acceptable to carers. Preliminary effectiveness analyses showed at least a small effect in acceptance, valued-living, grief and psychological distress.

scholarly journals Effects of Reflexology on the Pain Intensity among Patients with Depression after Receiving Electroconvulsive Therapy: A Randomized Clinical Trial

2021 ◽  
Vol 10 (3) ◽  
pp. 129-136
Author(s):  
Maryam Aliashraf Jodat ◽  
Leyla Alilu ◽  
Sohila Ahangarzadeh Rezayee ◽  
Rasool Gharaaghaji Asl
Keyword(s):  
Pain Intensity ◽  
Health Care Providers ◽  
Electroconvulsive Therapy ◽  
Muscle Pain ◽  
Repeated Measures ◽  
Intervention Group ◽  
Control Group ◽  
Care Providers ◽  
Significant Difference ◽  
The Mean

Introduction: High prevalence of psychiatric disorders and the high effectiveness of electroconvulsive therapy (ECT) have made this treatment a useful intervention. Memory impairment, headache, and muscle pain are the most important complications after ECT. This research aimed to determine the effect of reflexology on the headache and muscle pain intensity of patients after receiving ECT. Methods: This randomized controlled trial was conducted in Razi teaching hospital of Urmia, Iran. A total of 56 patients with depression receiving ECT were randomly assigned into two equal groups of control (n=28) and intervention (n=28). In the intervention group, reflexology was performed for 20 minutes at reflex points and, in the control group, only the conventional measures were taken. Pain intensity was measured with visual analogue scale (VAS) before and 1, 6, and 24 hours after the intervention. Data were analyzed using the SPSS software version 13. Furthermore, chi-square, Mann-Whitney, Wilcoxon, and repeated-measures tests were performed. Results: The mean difference in the severity of headache and muscle pain in the intervention group was significantly reduced compared to the control group. Moreover, the results demonstrated a significant difference between the mean headache and muscle pain in the two groups after the intervention. Conclusion: The results of this study showed the positive effect of reflexology on reducing the intensity of pain in patients receiving ECT. Thus, it is recommended that nurses, health care providers, and caregivers use reflexology to reduce pain in patients with depression receiving ECT.

scholarly journals Assessment of pain levels in patients undergoing foot surgery

2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Gabriel Souza De Albuquerque ◽  
Marcelo De Brito Teixeira ◽  
Miguel Lanzieri Juste ◽  
Daniel Gomes de Aguiar Melo ◽  
Lucas Jorge Santana de Castro Alves ◽  
...  
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
Opioid Use ◽  
Foot Surgery ◽  
Level Of Evidence ◽  
Vas Score ◽  
Post Surgery ◽  
Randomized Clinical Study ◽  
The Mean

Objective: To analyze the use of an anesthetic ankle block in the immediate postoperative period in patients undergoing foot surgery to evaluate the quality of postoperative recovery and in-hospital opioid use. Methods: Presentation of the preliminary results of a randomized, placebo-controlled, double-blind trial conducted from May 2016 to January 2017, with 16 patients undergoing surgery to correct foot pathologies. The patients in the intervention group were treated with an additional ankle block and compared to a control group. Results: The intervention group included eleven patients, of whom ten had mild pain, with a mean visual analog pain scale (VAS) score of 3 and a mean quality of post-surgical recovery (QoR-40) of 194; none of these patients required the use of opioids. The control group included five patients. Of these, one patient had severe pain and two showed moderate pain. The mean VAS score in this group was 4, and the mean QoR-40 was 190. Three patients from this group required opioids. Conclusion: The use of an ankle block in the 24 h immediately post-surgery reduced pain scores and the need for opioid use and improvedpostoperative recovery. Level of Evidence I; Therapeutic Studies; Randomized Clinical Study. 

scholarly journals The Efficacy of topical Capsaicin in the management of painful diabetic peripheral neuropathy: A unicenter double-blind, randomized clinical trial

2020 ◽  
Author(s):  
Batakeh Ba Agoons ◽  
Mesmin Dehayem ◽  
Martine Claude Etoa Etoga ◽  
Dayawa Da Agoons ◽  
Faustin Yepnjio ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Pain Intensity ◽  
Diabetic Peripheral Neuropathy ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
Sub Saharan ◽  
Topical Capsaicin

Abstract Background: Painful peripheral neuropathy is a common complication of diabetes and its management is difficult. Neurotropic drugs, which are the drugs of choice, have moderate efficacy due to high first pass metabolism. Topical Capsaicin, derived from the capsicum plant, is effective in relieving the pain of diabetic peripheral neuropathy in Caucasians. Due to an intercultural bias in pain treatment response, we evaluated the efficacy of Capsaicin on painful diabetic neuropathy in sub-Saharan subjectsMethods: 22 subjects with type 2 diabetes having painful diabetic polyneuropathy were randomly assigned using a 1:1 blocking pattern, with parallel design, to an intervention group of capsaicin cream, or to a control group of Miconazole cream. Participants and investigators were blinded to the randomization. Both groups applied the supplied drug topically three times daily for 08 weeks. Pain intensity was noted in both groups, using a visual analogue scale, at intervals of 2 weeks. The trial took place at the national obesity center in Cameroon. The primary analysis was intention-to-treat, and compared the reduction in the mean pain score from baseline, per 2 week period.Results: Twenty-two patients, aged 55 ± 7 years, with an average pain intensity of 6.3 units in the Capsaicin group and 5.8 units in the placebo group were included; at inclusion, there was no significant difference in the 2 groups (p=0.52). After 02 weeks, the mean value of pain intensity was 3.3±0.9 vs 5.4±1.7 (p=0.004), at week 4, 3.2±0.9 vs 4.7±1.2 (p=0,015), at week 6, 3.5±1.3 vs 4.8±1.3 (p=0.018) and at week 8, 6.6±1.1 vs 5.4±1.0 (p=0.55) for capsaicin and placebo respectively. The main side effect in the capsaicin group was burning sensations in the application zonesConclusion: Capsaicin significantly reduced neuropathic pain in the intervention group; however the pain worsened at week 8. It therefore has a transient positive effect on neuropathic pain in sub-Saharan subjects

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