Yoga and Physical Therapy for Chronic Pain and Opioid Use Disorder Onsite in an Opioid Treatment Program: A Randomized Controlled Trial.

Autor:	Groeger JL; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA.; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Perez HR; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA.; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Moonaz S; Department of Health Services Research, Southern California University of Health Sciences, Whittier, CA, USA., Bartels MN; Department of Rehabilitation Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA., Rand S; Department of Rehabilitation Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA., Ghiroli MM; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA., Zhang C; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA.; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Bao Y; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA., Gabbay V; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA.; Department of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA., Estremera GV; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Bryant G; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Hidalgo J; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA., Hribar MB; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Rodgers CRR; Department of Pediatrics, The Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA., Savitzky J; Department of Rehabilitation Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA., Stein MR; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA.; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.; Division of Services for Addiction, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA., Uebelacker LA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.; Psychosocial Research Program, Butler Hospital, Providence, RI, USA., Starrels JL; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA.; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA., Nahvi S; Division of General Internal Medicine, Montefiore Health System, Bronx, NY, USA.; Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA.; Division of Services for Addiction, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA.
Jazyk:	angličtina
Zdroj:	Substance use & addiction journal [Subst Use Addctn J] 2024 Aug 01, pp. 29767342241265929. Date of Electronic Publication: 2024 Aug 01.
DOI:	10.1177/29767342241265929
Abstrakt:	Background: There is a lack of integrated treatment for chronic pain and opioid use disorder (OUD). Yoga and physical therapy (PT) may improve pain and physical function of people living with (PLW) chronic low back pain (CLBP) and may also reduce opioid craving and use, but PLW with OUD face barriers to accessing these interventions. We hypothesize that compared to treatment as usual (TAU), providing yoga and PT onsite at opioid treatment programs (OTPs) will be effective at improving pain, opioid use, and quality of life among people with CLBP and OUD, and will be cost-effective. Methods: In this hybrid type-1 effectiveness-implementation study, we will randomly assign 345 PLW CLBP and OUD from OTPs in the Bronx, NY, to 12 weeks of onsite yoga, onsite PT, or TAU. Primary outcomes are pain intensity, opioid use, and cost-effectiveness. Secondary outcomes include physical function and overall well-being. Discussion: This trial tests an innovative, patient-centered approach to combined management for pain and OUD in real-world settings. We rigorously examine the efficacy of yoga and PT onsite at OTPs as nonpharmacologic, cost-effective treatments among people with CLBP and OUD who face barriers to integrated care. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JLS, VG, JLG, HRP, LAU, SN receive current grant support from NIH/NIDA. MNB, LAU, and VG receive current grant support for NIH/NIMH. LAU receives current grant support form NIH/NCCIH, NIH/NIA, and PCORI. JLS receives current grant support from AHRQ. VG receives current grant support from NIAID as part of the Einstein-Rockefeller-CUNY-CFAR. JLG receives an honorarium for contributing to AHRQ’s Opioids in Older Adults Technical Expert Panel and co-chairs the Geriatric and Older Adults Special Interest group at the Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) and the Alcohol, Tobacco, and Other Drug Use Special Interest Group for the American Geriatrics Society. LAU co-Chairs the Integrative Health & Spirituality Special Interest Group for the Society of Behavioral Medicine and participates on a Data Safety Monitoring Board or Advisory Board for 1R01AT012069; R61AG080615, R01DA057443, and R61MH129407. MRS is a paid contributor to UptoDate. MBH receives a consulting fee from EHE Medical—Medical Advisory Board. Yoga for Arthritis is a DBA sole proprietorship that provides continuing education programs for yoga professionals to work safely with chronic pain populations; it includes intellectual property developed by SMH who does not receive financial payments but does own the business. LAU co-Chairs the Integrative Health & Spirituality Special Interest Group for the Society of Behavioral Medicine and participates on a Data Safety Monitoring Board or Advisory Board for 1R01AT012069; R61AG080615, R01DA057443, and R61MH129407. LAU’s spouse is has stock options and is employed by Abbvie Pharmaceuticals, a company unrelated to this topic. Pfizer provided active and placebo varenicline until 2/2022 for a research study conducted by SN and funded by NIH/NIDA (R01DA042813).
Databáze:	MEDLINE
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