Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study)
Autor/a
Sanabria-Mazo, Juan P.
Garcia Forero, Carlos
Cristobal-Narváez, Paula
Suso-Ribera, Carlos
García-Palacios, Azucena
Colomer-Carbonell, Ariadna
Pérez-Aranda, Adrián
Andrés-Rodríguez, Laura
McCracken, Lance M.
D'Amico, Francesco
Estivill-Rodríguez, Pere
Carreras-Marcos, Bernat
Montes-Pérez, Antonio
Comps-Vicente, Olga
Esteve, Montserrat
Grasa, Mar
Rosa, Araceli
Cuesta-Vargas, Antonio I.
Maes, Michael
Borràs, Xavier
Edo, Silvia
Sanz, Antoni
Feliu-Soler, Albert
Castaño-Asins, Juan R.
Luciano, Juan V.
Data de publicació
2020ISSN
2044-6055
Resum
Introduction The IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre–post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes. Methods and analysis Participants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed. Ethics and dissemination This study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities.
Tipus de document
Article
Versió del document
Versió publicada
Llengua
English
Matèries (CDU)
159.9 - Psicologia
61 - Medicina
Paraules clau
Dolor lumbar crònic
Depressió
Teràpia d’acceptació i compromís
Tractament breu d’activació conductual per a la depressió
Dolor persistent
Dolor lumbar crónico
Depresión
Terapia de aceptación y compromiso
Tratamiento breve de activación conductual para la depresión
Dolor persistente
Chronic low back pain
Depression
Acceptance and commitment therapy
Brief behavioral activation treatment for depression
Persistent pain
Pàgines
13
Publicat per
BMJ Publishing Group
Col·lecció
10; 7
Publicat a
BMJ Open
Citació
Sanabria-Mazo, Juan P.; Garcia Forero, Carlos; Cristobal-Narváez, Paula [et al.]. Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study). BMJ Open, 2020, 10, e038107. Disponible en: <https://bmjopen.bmj.com/content/10/7/e038107>. Fecha de acceso: 14 sep. 2021. DOI: 10.1136/bmjopen-2020-038107
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