Background: To facilitate adherence to adaptive pain management behaviors after interdisciplinary multimodal pain treatment, we developed a mobile health app (AGRIPPA app) that contains two behavior regulation strategies. Objective: The aims of this project are (1) to test the effectiveness of the AGRIPPA app on pain disability; (2) to determine the cost-effectiveness; and (3) to explore the levels of engagement and usability of app users. Methods: We will perform a multicenter randomized controlled trial with two parallel groups. Within the 12-month inclusion period, we plan to recruit 158 adult patients with chronic pain during the initial stage of their interdisciplinary treatment program in one of the 6 participating centers. Participants will be randomly assigned to the standard treatment condition or to the enhanced treatment condition in which they will receive the AGRIPPA app. Patients will be monitored from the start of the treatment program until 12 months posttreatment. In our primary analysis, we will evaluate the difference over time of pain-related disability between the two conditions. Other outcome measures will include health-related quality of life, illness perceptions, pain self-efficacy, app system usage data, productivity loss, and health care expenses. Results: The study was approved by the local Medical Research Ethics Committee in October 2019. As of March 20, 2020, we have recruited 88 patients. Conclusions: This study will be the first step in systematically evaluating the effectiveness and efficiency of the AGRIPPA app. After 3 years of development and feasibility testing, this formal evaluation will help determine to what extent the app will influence the maintenance of treatment gains over time. The outcomes of this trial will guide future decisions regarding uptake in clinical practice.
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Background and objectives: Although Interdisciplinary Multimodal Pain Treatment (IMPT) programmes share a biopsychosocial approach to increase the wellbeing of patients with chronic pain, substantial variation in content and duration have been reported. In addition, it is unclear to what extent any favourable health outcomes are maintained over time. Therefore, our first aim was to identify and analyse the change over time of patient-related outcome measures in cohorts of patients who participated in IMPT programmes. Our second aim was to acquire insight into the heterogeneity of IMPT programmes. Databases and data treatment: The study protocol was registered in Prospero under CRD42018076093. We searched Medline, Embase, PsycInfo and Cinahl from inception to May 2020. All study selection, data extraction and risk of bias assessments were independently performed by two researchers. Study cohorts were eligible if they included adult patients with chronic primary musculoskeletal pain for at least 3 months. We assessed the change over time, by calculating pre-post, post-follow-up and pre-follow-up contrasts for seven different patient-reported outcome domains. To explore the variability between the IMPT programmes, we summarized the patient characteristics and treatment programmes using the intervention description and replication checklist. Results: The majority of the 72 included patient cohorts significantly improved during treatment. Importantly, this improvement was generally maintained at follow-up. In line with our expectations and with previous studies, we observed substantial methodological and statistical heterogeneity. Conclusions: This study shows that participation in an IMPT programme is associated with considerable improvements in wellbeing that are generally maintained at follow-up. The current study also found substantial heterogeneity in dose and treatment content, which suggests different viewpoints on how to optimally design an IMPT programme. Significance: The current study provides insight into the different existing approaches regarding the dose and content of IMPT programs. This analysis contributes to an increased understanding of the various approaches by which a biopsychosocial perspective on chronic pain can be translated to treatment programs. Furthermore, despite theoretical and empirical assertions regarding the difficulty to maintain newly learned health behaviors over time, the longitudinal analysis of health outcomes did not find a relapse pattern for patients who participated in IMPT programs.
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Background: Although interdisciplinary multimodal pain treatment (IMPT) programs are widely regarded as treatment of choice for patients with chronic pain, there are signs that many patients are unable to maintain their treatment gains in the long term. To facilitate the maintenance of positive treatment outcomes over time, we developed two relapse prevention strategies. Objective: The main objective of this study was to explore the feasibility of these strategies within the context of IMPT programs. Methods: We performed a feasibility study using 3 workbook prototypes containing either one or both strategies. For a period of 6 months, the workbooks were made available in two IMPT facilities. Qualitative data were collected through a focus group and semistructured interviews. We performed a thematic analysis using a deductive approach with (1) applicability to the treatment program, (2) acceptability of the workbook content, and (3) form, as predefined themes. Results: The final dataset consisted of transcripts from a focus group with health care providers and 11 telephone interviews and 2 additional in-depth interviews with patients. In general, the intervention was perceived as useful, easy to use, and in line with the treatment program. The data also include suggestions to further improve the use of both strategies, including more specific implementation guidelines, revised goal-setting procedure, and development of a mobile health version. However, several factors, including a high dropout rate and small sample size, impact the external validity of our findings. Conclusions: This study should be regarded as a first step in the process of transforming the prototype workbook into an effective intervention for clinical practice. Although these initial results indicate a favorable evaluation of both behavior regulation strategies within the workbook, this study encountered multiple barriers regarding implementation and data collection that limit the generalizability of these results. Future research efforts should specifically address the fidelity of HCPs and patients and should include clear procedures regarding recruitment and use of both relapse prevention strategies during treatment.
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Mycelium biocomposites (MBCs) are a fairly new group of materials. MBCs are non-toxic and carbon-neutral cutting-edge circular materials obtained from agricultural residues and fungal mycelium, the vegetative part of fungi. Growing within days without complex processes, they offer versatile and effective solutions for diverse applications thanks to their customizable textures and characteristics achieved through controlled environmental conditions. This project involves a collaboration between MNEXT and First Circular Insulation (FC-I) to tackle challenges in MBC manufacturing, particularly the extended time and energy-intensive nature of the fungal incubation and drying phases. FC-I proposes an innovative deactivation method involving electrical discharges to expedite these processes, currently awaiting patent approval. However, a critical gap in scientific validation prompts the partnership with MNEXT, leveraging their expertise in mycelium research and MBCs. The research project centers on evaluating the efficacy of the innovative mycelium growth deactivation strategy proposed by FC-I. This one-year endeavor permits a thorough investigation, implementation, and validation of potential solutions, specifically targeting issues related to fungal regrowth and the preservation of sustained material properties. The collaboration synergizes academic and industrial expertise, with the dual purpose of achieving immediate project objectives and establishing a foundation for future advancements in mycelium materials.
