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Sud A, Nelson MLA, Cheng DK, Armas A, Foat K, Greiver M, Hosseiny F, Katz J, Moineddin R, Mulsant BH, Newman RI, Rivlin L, Vasudev A, Upshur R. Sahaj Samadhi Meditation versus a Health Enhancement Program for depression in chronic pain: protocol for a randomized controlled trial and implementation evaluation. Trials 2020; 21:319. [PMID: 32264945 PMCID: PMC7140371 DOI: 10.1186/s13063-020-04243-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/10/2020] [Indexed: 11/16/2022] Open
Abstract
Background Despite the high prevalence of comorbid chronic pain and depression, this comorbidity remains understudied. Meditation has demonstrated efficacy for both chronic pain and depression independently, yet there have been few studies examining its effectiveness when both conditions are present concurrently. Furthermore, while meditation is generally accepted as a safe and effective health intervention, little is known about how to implement meditation programs within or alongside the health care system. Methods We will conduct a hybrid type 1 effectiveness–implementation evaluation. To measure effectiveness, we will conduct a randomized controlled trial comparing Sahaj Samadhi Meditation and the Health Enhancement Program in 160 people living with chronic pain, clinically significant depressive symptoms, and on long-term opioid therapy. Changes in depressive symptoms will be our primary outcome; pain severity, pain-related function, opioid use, and quality of life will be the secondary outcomes. The primary end point will be at 12 weeks with a secondary end point at 24 weeks to measure the sustainability of acute effects. Patients will be recruited from a community-based chronic pain clinic in a large urban center in Mississauga, Canada. The meditation program will be delivered in the clinical environment where patients normally receive their chronic pain care by certified meditation teachers who are not regulated health care providers. We will use a mixed-methods design using the multi-level framework to understand the implementation of this particular co-location model. Discussion Results of this hybrid evaluation will add important knowledge about the effectiveness of meditation for managing depressive symptoms in people with chronic pain. The implementation evaluation will inform both effectiveness outcomes and future program development, scalability, and sustainability. Trial registration ClinicalTrials.gov: NCT04039568. Registered on 31 July 2019.
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Affiliation(s)
- Abhimanyu Sud
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. .,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Michelle L A Nelson
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Darren K Cheng
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Alana Armas
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | | | - Michelle Greiver
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Family and Community Medicine, North York General Hospital, Toronto, ON, Canada
| | | | - Joel Katz
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ronnie I Newman
- Research and Health Promotion Department, Art of Living Foundation (North America), Saint-Mathieu-du-Parc, QC, Canada.,Lifelong learning Institute, Health Professions Division, Nova Southeastern University, Davie, FL, USA
| | - Leon Rivlin
- Rivlin Medical Group, Mississauga, ON, Canada.,Emergency Medicine, Humber River Hospital, Toronto, ON, Canada
| | - Akshya Vasudev
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Neuroscience, Western University, London, ON, Canada.,Geriatric Mood Disorders Lab, Lawson Health Research Institute, Parkwood Institute of Mental Health Care, London, ON, Canada
| | - Ross Upshur
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Dikaios E, Sekhon H, Allard A, Vacaflor B, Goodman A, Dwyer E, Lavin-Gonzalez P, Mahdanian A, Park H, Walsh C, Sasi N, Nazar R, Gruber J, Su CL, Hanganu C, Royal I, Schiavetto A, Cinalioglu K, Rigas C, Launay C, Beauchet O, McDonald E, Seitz D, Kumar S, Nair V, Miresco M, Bruneau MA, Alexopoulos G, Looper K, Vahia I, Rej S, Bukhari SN. Connecting During COVID-19: A Protocol of a Volunteer-Based Telehealth Program for Supporting Older Adults' Health. Front Psychiatry 2020; 11:598356. [PMID: 33343425 PMCID: PMC7738321 DOI: 10.3389/fpsyt.2020.598356] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/26/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction: Social-distancing due to COVID-19 has led to social isolation, stress, and mental health issues in older adults, while overwhelming healthcare systems worldwide. Telehealth involving phone calls by trained volunteers is understudied and may be a low-cost, scalable, and valuable preventive tool for mental health. In this context, from patient participatory volunteer initiatives, we have adapted and developed an innovative volunteer-based telehealth intervention program for older adults (TIP-OA). Methods and analysis: To evaluate TIP-OA, we are conducting a mixed-methods longitudinal observational study. Participants: TIP-OA clients are older adults (age ≥ 60) recruited in Montreal, Quebec. Intervention: TIP-OA volunteers make weekly friendly phone calls to seniors to check in, form connections, provide information about COVID-19, and connect clients to community resources as needed. Measurements: Perceived stress, fear surrounding COVID-19, depression, and anxiety will be assessed at baseline, and at 4- and 8-weeks. Semi-structured interviews and focus groups will be conducted to assess the experiences of clients, volunteers, and stakeholders. Results: As of October 15th, 2020, 150 volunteers have been trained to provide TIP-OA to 305 older clients. We will consecutively select 200 clients receiving TIP-OA for quantitative data collection, plus 16 volunteers and 8 clinicians for focus groups, and 15 volunteers, 10 stakeholders, and 25 clients for semi-structured interviews. Discussion: During COVID-19, healthcare professionals' decreased availability and increased needs related to geriatric mental health are expected. If successful and scalable, volunteer-based TIP-OA may help prevent and improve mental health concerns, improve community participation, and decrease healthcare utilization. Clinical Trial Registration: ClinicalTrials.gov NCT04523610; https://clinicaltrials.gov/ct2/show/NCT04523610?term=NCT04523610&draw=2&rank=1.
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Affiliation(s)
- Elena Dikaios
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
| | - Harmehr Sekhon
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Alexandre Allard
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Blanca Vacaflor
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Allana Goodman
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Emmett Dwyer
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Paola Lavin-Gonzalez
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Artin Mahdanian
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Haley Park
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Chesley Walsh
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Neeti Sasi
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
| | - Rim Nazar
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
| | - Johanna Gruber
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Chien-Lin Su
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Cezara Hanganu
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Isabelle Royal
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Alessandra Schiavetto
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Karin Cinalioglu
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
| | - Christina Rigas
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada
| | - Cyrille Launay
- Division of Geriatric Medicine, Jewish General Hospital, Montreal, QC, Canada
| | - Olivier Beauchet
- Division of Geriatric Medicine, Jewish General Hospital, Montreal, QC, Canada
| | - Emily McDonald
- McGill University Health Center Research Institute (RI-MUHC), Montreal, QC, Canada.,Division of General Internal Medicine, McGill University, Montreal, QC, Canada
| | - Dallas Seitz
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Sanjeev Kumar
- Center for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vasavan Nair
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Marc Miresco
- Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Marie-Andrée Bruneau
- Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - George Alexopoulos
- Department of Psychiatry, Weill Medical College of Cornell University, New York, NY, United States
| | - Karl Looper
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, QC, Canada
| | - Ipsit Vahia
- Department of Psychiatry and Harvard Medical School, Boston, MA, United States
| | - Soham Rej
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Syeda Nayab Bukhari
- McGill Meditation and Mind-Body Medicine Research Clinic and GeriPARTy Research Group, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
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