NCT04290845

Brief Summary

Chronic pain and depression frequently co-exist in late and mid-life and contribute to increased disability, high health care costs, psychiatric comorbidity, and suicide. Older and middle-aged depressed-pain patients: a) are mainly treated in primary care practices; and b) are often prescribed medication, which increases the risk for addiction to opioids and benzodiazepines. Despite the need and desire by the patients and providers for primary care behavioral intervention, behavioral interventions are scarce in primary care. To address this need, Relief-Hybrid was created. Subjects are randomized to either the Relief-Hybrid intervention or to Referral to Mental Health/Usual Care. Subjects in both arms will complete research assessments at 6, 9, and 12 weeks. Subjects in the Relief-Hybrid arm will receive 5 weekly sessions with the study therapist (licensed social workers, LCSWs) and 4 self-administered, mobile technology-assisted sessions.

Trial Health

30
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Timeline
Completed

Started Feb 2023

Geographic Reach
1 country

4 active sites

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 27, 2020

Completed
4 days until next milestone

First Posted

Study publicly available on registry

March 2, 2020

Completed
2.9 years until next milestone

Study Start

First participant enrolled

February 1, 2023

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2023

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2024

Completed
Last Updated

March 24, 2023

Status Verified

March 1, 2023

Enrollment Period

10 months

First QC Date

February 27, 2020

Last Update Submit

March 21, 2023

Conditions

Keywords

Chronic PainDepressionPrimary CareOlder AdultsMiddle Aged

Outcome Measures

Primary Outcomes (3)

  • Change in depression symptoms, as measured by the Montgomery Asberg Depression Rating Scale (MADRS)

    The MADRS is a 10 item questionnaire assessing severity of depression by scoring participants on mood, anxiety, sleep, concentration, appetite, and suicidal thoughts. The lowest score is 0, no depression symptoms, and the highest possible score is 60, severe depression symptoms.

    Baseline, 6, 9, and 12 weeks

  • Change in Pain-Related Disability, as measured by the Roland-Morris Disability Questionnaire (RMDQ)

    The RMDQ includes a scale assessing how much pain the participant has experienced in the past week, with 0 meaning no pain and 10 meaning pain as bad as he/she can imagine. The RMDQ also includes a series of questions related to pain disability, with 0 indicating no pain-related disability, and 24 indicating severe pain-related disability.

    Baseline, 6, 9, and 12 weeks

  • Change in Mood, as measured by the Daily Photographic Affect Meter (PAM)

    The PAM is used for assessing mood and emotional state. Participants can either score a "positive" or "negative" affect value.

    Daily for 12 Weeks

Secondary Outcomes (7)

  • Interoceptive Awareness, as measured by the Multidimensional Assessment of Interoceptive Awareness (MAIA)

    Baseline, 6, 9, and 12 weeks

  • Affect, as measured by the Positive and Negative Affect Schedule (PANAS).

    Baseline, 6, 9, and 12 weeks

  • Mood, as measured by the Mood Likert Scale

    Daily for 12 weeks

  • Pain, as measured by the Pain Likert Scale

    Daily for 12 weeks

  • Stress, as measured by the Stress Likert Scale

    Daily for 12 weeks

  • +2 more secondary outcomes

Study Arms (2)

Relief-Hybrid

EXPERIMENTAL

Relief-Hybrid relies on a neurobiological model to simplify its behavioral targets and uses mobile technology to augment its interventions. Relief was co-developed with our primary care partners with the goal to be usable by non-physician clinicians of primary care offices eligible to provide billable services.

Behavioral: Relief-Hybrid

Referral to Mental Health/Usual Care

NO INTERVENTION

Continuation of medical attention and treatment provided by physicians and other medical professionals at the primary care practice. Referral for mental health based on clinical indication. Participants receive an educational booklet on pain.

Interventions

Relief-HybridBEHAVIORAL

A 9-week behavioral intervention for primary care patients designed to reduce depression and pain-related disability.

Relief-Hybrid

Eligibility Criteria

Age50 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • years or older
  • PHQ-9 score greater or equal to 10
  • Chronic pain (non-cancer related, most days over the past 3 months)
  • Capacity to consent

You may not qualify if:

  • DSM-5 Axis 1 diagnoses other than depression and anxiety disorders
  • Montreal Cognitive Assessment (MoCA) \< 24
  • Active suicidal ideation (MADRS item #10 greater or equal to 4
  • Severe or life-threatening medical illness
  • Patients on psychotropics, opioids or benzodiazepines will be included if they do not meet DSM-5 criteria for opioid, anxiolytics or other substance abuse disorders

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Weill Cornell Internal Medical Associates (WCIMA)

New York, New York, 10021, United States

Location

Iris Cantor Men's and Women's Health Centers

New York, New York, 10065, United States

Location

Irving Sherwood Wright Center

New York, New York, 10075, United States

Location

Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine

White Plains, New York, 10605, United States

Location

MeSH Terms

Conditions

Chronic PainDepression

Condition Hierarchy (Ancestors)

PainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsBehavioral SymptomsBehavior

Study Officials

  • Dimitris Kiosses, PhD

    Weill Medical College of Cornell University

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Research assistants will be blinded as to who is receiving Relief-Hybrid and who is receiving Usual Care.
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 27, 2020

First Posted

March 2, 2020

Study Start

February 1, 2023

Primary Completion

December 1, 2023

Study Completion

December 1, 2024

Last Updated

March 24, 2023

Record last verified: 2023-03

Data Sharing

IPD Sharing
Will share

De-identified data from this study is submitted to the National Database for Clinical Trials related to Mental Illness (NDCT). The NDCT is run by NIH and allows researchers studying mental health to collect and share information with each other. Researchers must apply to NIH in order to be allowed access to the data for 1 year's time; after which they must re-apply.

Time Frame
Data will be available as per NIH's data sharing policy.
Access Criteria
Access criteria is determined by NIH and can be requested by applying online.
More information

Locations