TY - JOUR
KW - Chronic Pain/therapy
KW - Humans
KW - Primary Health Care
KW - Qualitative Research
KW - Safety-net Providers
KW - Telemedicine
KW - Alcohol
KW - Chronic Pain
KW - Heavy drinking
KW - primary care
KW - self-management
AU - T. P. Palfai
AU - M. P. L. Kratzer
AU - N. E. Morone
AU - J. A. Bernstein
A1 - 
AB - BACKGROUND: Chronic pain and heavy drinking are conditions that commonly co-occur among primary care patients. Despite the availability of behavioral interventions that target these conditions individually, engagement and adherence to treatment remain a challenge, and there have been no interventions designed to address both of these conditions together for patients presenting to primary care. This study seeks to incorporate the perspectives of patients regarding symptoms, treatment experiences, views on behavior change, and technology use to develop a tailored, integrated mobile health intervention that addresses both pain and heavy drinking among patients in primary care. METHODS: Twelve participants with moderate or greater chronic pain intensity and heavy drinking were recruited from primary care clinics in a large urban safety-net hospital. One-on-one interviews were recorded and transcribed. Codes were developed from interview transcripts, followed by thematic analysis in which specific meanings were assigned to codes. Participants also completed a series of Likert-based rating scales to evaluate components of the proposed intervention to supplement qualitative interviews. RESULTS: A number of themes were identified that had implications for intervention tailoring including: ambivalence about changing drinking, low expectations about pain treatment success, desire for contact with a designated provider, common use of smartphones but lack of familiarity with functions as a potential barrier to use, and strategies to maintain engagement and adherence. Evaluative ratings indicated that the proposed intervention content was perceived as helpful and the proposed structure, layout and design of the mobile intervention was acceptable to patients. CONCLUSIONS: Results supported the view that a mobile health intervention delivered via smartphone with electronic coaching is an acceptable method of addressing chronic pain and heavy drinking among patients in primary care. The interviews highlight the need to utilize an intervention approach that addresses motivation to change drinking, sets realistic expectations for change, provides careful attention to training/education of the use of technology components, and fosters engagement through the use of reminders, feedback, and personalized activities.
AD - Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., Boston, MA, 02215, USA. palfai@bu.edu.; Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., Boston, MA, 02215, USA.; Department of Medicine, Section of Internal Medicine, Boston University School of Medicine, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA.; Department of Community Health Sciences, School of Public Health, Boston University, 801 Massachusetts Ave, 4th Floor, Boston, MA, 02118, USA.
BT - Addiction science & clinical practice
C5 - Healthcare Disparities; HIT & Telehealth; Opioids & Substance Use
CP - 1
DO - 10.1186/s13722-021-00230-0
IS - 1
JF - Addiction science & clinical practice
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Chronic pain and heavy drinking are conditions that commonly co-occur among primary care patients. Despite the availability of behavioral interventions that target these conditions individually, engagement and adherence to treatment remain a challenge, and there have been no interventions designed to address both of these conditions together for patients presenting to primary care. This study seeks to incorporate the perspectives of patients regarding symptoms, treatment experiences, views on behavior change, and technology use to develop a tailored, integrated mobile health intervention that addresses both pain and heavy drinking among patients in primary care. METHODS: Twelve participants with moderate or greater chronic pain intensity and heavy drinking were recruited from primary care clinics in a large urban safety-net hospital. One-on-one interviews were recorded and transcribed. Codes were developed from interview transcripts, followed by thematic analysis in which specific meanings were assigned to codes. Participants also completed a series of Likert-based rating scales to evaluate components of the proposed intervention to supplement qualitative interviews. RESULTS: A number of themes were identified that had implications for intervention tailoring including: ambivalence about changing drinking, low expectations about pain treatment success, desire for contact with a designated provider, common use of smartphones but lack of familiarity with functions as a potential barrier to use, and strategies to maintain engagement and adherence. Evaluative ratings indicated that the proposed intervention content was perceived as helpful and the proposed structure, layout and design of the mobile intervention was acceptable to patients. CONCLUSIONS: Results supported the view that a mobile health intervention delivered via smartphone with electronic coaching is an acceptable method of addressing chronic pain and heavy drinking among patients in primary care. The interviews highlight the need to utilize an intervention approach that addresses motivation to change drinking, sets realistic expectations for change, provides careful attention to training/education of the use of technology components, and fosters engagement through the use of reminders, feedback, and personalized activities.
PY - 2021
SN - 1940-0640; 1940-0632; 1940-0632
SP - 20
T1 - Integrating patient perspectives in the development of a mobile health intervention to address chronic pain and heavy drinking in primary care: A qualitative study of patients in an urban, safety-net hospital setting
T2 - Addiction science & clinical practice
TI - Integrating patient perspectives in the development of a mobile health intervention to address chronic pain and heavy drinking in primary care: A qualitative study of patients in an urban, safety-net hospital setting
U1 - Healthcare Disparities; HIT & Telehealth; Opioids & Substance Use
U2 - 33757584
U3 - 10.1186/s13722-021-00230-0
VL - 16
VO - 1940-0640; 1940-0632; 1940-0632
Y1 - 2021
Y2 - Mar 23
ER -