PMID- 37362184
OWN - NLM
STAT- Publisher
LR  - 20230928
IS  - 1868-8527 (Print)
IS  - 1868-8535 (Electronic)
IS  - 1868-8527 (Linking)
DP  - 2023 May 24
TI  - Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time 
      Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic 
      Pain.
PG  - 1-17
LID - 10.1007/s12671-023-02137-0 [doi]
AB  - OBJECTIVE: The opioid crisis in the USA remains severe during the COVID-19 
      pandemic, which has reduced access to evidence-based interventions. This Stage 1 
      randomized controlled trial (RCT) assessed the preliminary efficacy of Zoom-based 
      Mindfulness-Oriented Recovery Enhancement (MORE) plus Just-in-Time Adaptive 
      Intervention (JITAI) prompts to practice mindfulness triggered by wearable 
      sensors (MORE + JITAI). METHOD: Opioid-treated chronic pain patients (n = 63) 
      were randomized to MORE + JITAI or a Zoom-based supportive group (SG) 
      psychotherapy control. Participants completed ecological momentary assessments 
      (EMA) of craving and pain (co-primary outcomes), as well as positive affect, and 
      stress at one random probe per day for 90 days. EMA probes were also triggered 
      when a wearable sensor detected the presence of physiological stress, as 
      indicated by changes in heart rate variability (HRV), at which time participants 
      in MORE + JITAI were prompted by an app to engage in audio-guided mindfulness 
      practice. RESULTS: EMA showed significantly greater reductions in craving, pain, 
      and stress, and increased positive affect over time for participants in 
      MORE + JITAI than for participants in SG. JITAI-initiated mindfulness practice 
      was associated with significant improvements in these variables, as well as 
      increases in HRV. Machine learning predicted JITAI-initiated mindfulness practice 
      effectiveness with reasonable sensitivity and specificity. CONCLUSIONS: In this 
      pilot trial, MORE + JITAI demonstrated preliminary efficacy for reducing opioid 
      craving and pain, two factors implicated in opioid misuse. MORE + JITAI is a 
      promising intervention that warrants investigation in a fully powered RCT. 
      PREREGISTRATION: This study is registered on ClinicalTrials.gov (NCT04567043).
CI  - (c) The Author(s), under exclusive licence to Springer Science+Business Media, LLC, 
      part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or 
      other partner) holds exclusive rights to this article under a publishing 
      agreement with the author(s) or other rightsholder(s); author self-archiving of 
      the accepted manuscript version of this article is solely governed by the terms 
      of such publishing agreement and applicable law.
FAU - Garland, Eric L
AU  - Garland EL
AD  - University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA. GRID: 
      grid.223827.e. ISNI: 0000 0001 2193 0096
AD  - Salt Lake VA Medical Center, Salt Lake City, USA. GRID: grid.413886.0
FAU - Gullapalli, Bhanu T
AU  - Gullapalli BT
AD  - University of California-San Diego, San Diego, USA. GRID: grid.266100.3. ISNI: 
      0000 0001 2107 4242
FAU - Prince, Kort C
AU  - Prince KC
AD  - University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA. GRID: 
      grid.223827.e. ISNI: 0000 0001 2193 0096
FAU - Hanley, Adam W
AU  - Hanley AW
AD  - University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA. GRID: 
      grid.223827.e. ISNI: 0000 0001 2193 0096
FAU - Sanyer, Mathias
AU  - Sanyer M
AD  - Utah State University, Logan, USA. GRID: grid.53857.3c. ISNI: 0000 0001 2185 8768
FAU - Tuomenoksa, Mark
AU  - Tuomenoksa M
AD  - Illumivu, Asheville, NC USA.
FAU - Rahman, Tauhidur
AU  - Rahman T
AD  - University of California-San Diego, San Diego, USA. GRID: grid.266100.3. ISNI: 
      0000 0001 2107 4242
LA  - eng
SI  - ClinicalTrials.gov/NCT04567043
GR  - R01 AT011772/AT/NCCIH NIH HHS/United States
GR  - R01 DA042033/DA/NIDA NIH HHS/United States
PT  - Journal Article
DEP - 20230524
PL  - United States
TA  - Mindfulness (N Y)
JT  - Mindfulness
JID - 101518348
PMC - PMC10205566
OTO - NOTNLM
OT  - Chronic pain
OT  - Craving
OT  - JITAI
OT  - Machine learning
OT  - Opioid misuse
OT  - mHealth
COIS- Conflict of InterestEric Garland, PhD, LCSW is the Director of the Center on 
      Mindfulness and Integrative Health Intervention Development. The Center provides 
      Mindfulness-Oriented Recovery Enhancement (MORE), mindfulness-based therapy, and 
      cognitive behavioral therapy in the context of research trials for no cost to 
      research participants; however, Dr. Garland has received payment for delivering 
      lectures, and teaching engagements (related to training clinicians in 
      mindfulness) sponsored by institutions of higher education, government agencies, 
      and medical centers. Dr. Garland also receives royalties from the sale of books 
      related to MORE. Dr. Garland is a licensor to BehaVR, LLC. Mark Tuomenoksa is the 
      Chief Technology Officer of Illumivu. No other authors have any related conflicts 
      of interest to disclose.
EDAT- 2023/06/26 19:07
MHDA- 2023/06/26 19:07
PMCR- 2023/05/24
CRDT- 2023/06/26 13:02
PHST- 2023/04/15 00:00 [accepted]
PHST- 2023/06/26 19:07 [pubmed]
PHST- 2023/06/26 19:07 [medline]
PHST- 2023/06/26 13:02 [entrez]
PHST- 2023/05/24 00:00 [pmc-release]
AID - 2137 [pii]
AID - 10.1007/s12671-023-02137-0 [doi]
PST - aheadofprint
SO  - Mindfulness (N Y). 2023 May 24:1-17. doi: 10.1007/s12671-023-02137-0.