Integrative Mindfulness-Based Predictive Approach for Chronic Low Back Pain Treatment

Purpose

This study will identify unique signatures that people have which can cause pain by evaluating biological, psychological, and social markers using artificial intelligence. These markers can be used to accurately predict the response of diverse individuals with chronic low back pain (cLBP) to Mindfulness-Based Stress Reduction. This will help enhance clinician decision-making and the targeted treatment of chronic pain. The overall objective is to use a unique machine learning (ML) approach to determine the biomarker signature of persons undergoing mindfulness based stress reduction (MBSR) treatment for their chronic low back pain (cLBP). This signature will facilitate clinical prediction and monitoring of patient response to MBSR treatment. The design of the study is a single-arm clinical trial of the evidence-based MBSR program for patients with cLBP.

Condition

  • Chronic Low-back Pain

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Chronic low back pain, which is pain that persists for at least 3-months and has resulted in pain on at least half the days in the past 6 months - Willing and able to provide online or telephone informed consent - Speak English as the intervention manual is currently written in English

Exclusion Criteria

  • Red flags- recent (past month) worsening of pain, unexplained fever, unexplained weight loss - Pregnancy - Metastatic cancer - Not a patient at a participating clinic or persons not planning to continue as a patient at a participating clinic for 6 or more months

Study Design

Phase
N/A
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Mindfulness based stress reduction (MBSR) program
Participants will be enrolled in a 8-week mindfulness clinical pain program + Primary Care Provider (PCP) Usual Care.
  • Behavioral: Mindfulness meditation
    Ordinary activities like breathing, eating, and walking are turned into a meditation by creating greater awareness of the moment-to-moment sensations, emotions, thoughts and behaviors that arise during these activities.
  • Other: Perspectives on pain
    Understanding pain from a mind-body perspective and viewing pain as a stressor on physical sensations, thoughts, emotions, and behavior.
  • Other: Discussion
    Discussion on patients' use of mindfulness to work with pain and pain-themed meditations.

Recruiting Locations

Boston Medical Center
Boston, Massachusetts 02116
Contact:
Natalia Morone, MD MS
617-414-6652
Natalia.Morone@bmc.org

More Details

Status
Recruiting
Sponsor
Boston Medical Center

Study Contact

Natalia Morone, MD MS
617-414-6652
Natalia.Morone@bmc.org

Detailed Description

UG3 Phase Overview. The first 24-months of the project will be dedicated to performing machine learning modeling to identify candidate predictive and monitoring markers of cLBP response to MBSR, prior to the full clinical trial in the UH3 phase. We will also refine our procedures such as recruitment and outcomes assessment with 50 persons during the UG3 phase. UH3 Phase Overview. Biopsychosocial markers will be identified of the response of diverse cLBP patients to MBSR (N=300) from comprehensive pain assessment and biopsychosocial data, including pain intensity and pain interference, physical activity, sleep, and heart rate for a 6-month period. Data will be collected and used for training and testing ML models. The MBSR program is evidence-based and meets weekly in a group via Zoom for 8-weeks for 90 minutes per week. Measures to determine biomarkers will be obtained at baseline (T1), four-weeks (T2), program completion (T3), four months (T4), and six months (T5). The main outcome timepoint with be at six months (T5), which allows time for durability of effects to be determined. The PEG (Pain, Enjoyment, General activity), obtained through online self-report surveys is the main outcome measure. Secondary outcomes of physical and psychological function will be self-report and obtained online, or if the patient prefers, by telephone, and physical activity, sleep, and heart rate variability will be collected by Fitbit.