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    HP:0003418: Back pain

    Developed by Shray Alag, The Harker School
    Sections: Correlations, Clinical Trials, and HPO

    Correlations computed by analyzing all clinical trials.

    Navigate: Clinical Trials and HPO

    Correlated Drug Terms (4)

    Name (Synonyms) Correlation
    drug774 COVID-19 patients Wiki 1.00
    drug2387 Mindfulness Meditation Wiki 0.71
    drug4614 non interventional Wiki 0.71
    Name (Synonyms) Correlation
    drug953 Cognitive Behavioral Therapy Wiki 0.41

    Correlated MeSH Terms (3)

    Name (Synonyms) Correlation
    D001416 Back Pain NIH 1.00
    D017116 Low Back Pain NIH 1.00
    D010146 Pain NIH 0.71

    Correlated HPO Terms (2)

    Name (Synonyms) Correlation
    HP:0003419 Low back pain HPO 1.00
    HP:0012531 Pain HPO 0.71

    Clinical Trials

    Navigate: Correlations   HPO

    There are 2 clinical trials

    1 A Comparative Effectiveness Randomized Controlled Trial of Mindfulness Meditation Versus Cognitive Behavioral Therapy for Opioid-Treated Chronic Low Back Pain

    Chronic low back pain (CLBP) has no known effective treatment. While often treated with long-term opioid therapy, opioids do not work well for many patients and can cause serious side effects, including addiction, poorer mental health, and overdose death. Even when paired with a standard-of-care cognitive behavioral therapy (CBT), results are limited. Patients, families and clinicians are very interested in using alternative treatments for CLBP, especially complementary and integrative treatments such as mindfulness meditation (MM). MM helps train the mind to bring non-judgmental and accepting attention to present-moment experiences such as pain. MM offers an active and safe self-care approach to chronic pain that contrasts with the passive and potentially harmful nature of opioid treatment, and may prove more effective than CBT in helping improve health and well-being, and reduce reliance on opioids in adults with opioid-treated CLBP. Although this hypothesis is supported by early research, including a pilot study by the Principal Investigator, evidence on MM's effectiveness in this population is inconclusive, presenting a critical knowledge gap. With input from patients, family members, and clinicians, the Investigators have designed a study to address this gap and propose a clinical trial that will compare the effectiveness of MM to standard-of-care CBT in opioid-treated CLBP. Based on the existing research, it is hypothesized that MM training will lead to a larger reduction in pain intensity, increase in physical function, improvement in quality of life, and decrease in daily opioid dose, as compared to CBT training, with benefits of MM especially notable in adults with worse mood, anxiety or unhealthy opioid-use behaviors who often experience more severe symptoms of CLBP and less improvement in response to existing therapies. To test these hypotheses, 766 adults with opioid-treated CLBP will be randomly assigned into one of two 8-week treatment groups: MM (383 participants) that will receive the MM training or CBT (383 participants) that will receive the CBT training. Due to the COVID-19 pandemic-related restrictions, the study protocol was modified in October 2020 so that the study can be completed virtually. The effectiveness of MM versus CBT will be assessed over a 12-month period with patient-reported measures, recommended by experts and endorsed by our stakeholder partners, including patients with opioid-treated CLBP, their families and clinicians.

    1. Chronic Low Back Pain
    1. Behavioral: Mindfulness Meditation
    2. Behavioral: Cognitive Behavioral Therapy
    MeSH:Back Pain Low Back Pain
    HPO:Back pain Low back pain

    Primary Outcomes

    Description: 4 pain severity items from the Brief Pain Inventory

    Measure: Pain Intensity

    Time: Baseline to 12 months

    Description: 10-item Oswestry Disability Index

    Measure: Physical Function

    Time: Baseline to 12 months

    Secondary Outcomes

    Description: 12-item Short Form-12

    Measure: Quality of Life

    Time: Baseline to 12 months

    Description: Timeline Followback Method (morphine-equivalent dose [mg/day] over the prior 14 days)

    Measure: Daily Opioid Dose

    Time: Baseline to 12 months

    Other Outcomes

    Description: 14-item Hospital Anxiety and Depression Scale

    Measure: Depression Symptom Severity

    Time: Baseline to 12 months

    Description: 14-item Hospital Anxiety and Depression Scale

    Measure: Anxiety Symptom Severity

    Time: Baseline to 12 months

    Description: 17-item Current Opioid Misuse Measure

    Measure: Opioid Use Behaviors

    Time: Baseline to 12 months

    Description: 8-item Opioid Compliance Checklist

    Measure: Opioid Medication Compliance

    Time: Baseline to 12 months
    2 Confinement Effect on Low Back Pain Intensity in Chronic Low Back Pain Patients

    The current situation, linked to the pandemic of the new coronavirus SARS-CoV-2 generates health concerns, but is also accompanied by many other psychological, social, economic, professional, etc. consequences as well as numerous changes in behavior and lifestyles, notably due to confinement. While the prevention of chronic low back pain and its management are primarily based on the practice of regular physical and sports activity, other psychological factors (stress, anxiety, depression), socioeconomic (low level of education, resources), professionals (physical workload, job dissatisfaction), etc. also have a major role in the onset and the persitence of low back pain. Thus, it is to be supposed that the current context, and more particularly the confinement to which the population has been constrained for almost 2 months, have and will have notable consequences on the evolution of lumbar symptoms in chronic low back pain patients. However, the entanglement of different factors related to containment will potentially have different consequences depending on the individual. It therefore seems difficult to predict how the lumbar symptoms will develop in this population. Indeed, if it can imagined that the decrease in regular physical activity and the increase in anxiety in this context of insecurity could lead to an increase in pain, it could just as well consider that the decrease in stress work, strenuous physical work or travel time from work to home can, on the contrary, have a favorable effect. The objective of this study is to assess the confinement effect on low back pain intensity in chronic low back pain patients. This is an observational, descriptive, transversal and pluricentric study conducted by a single questionnaire.

    1. Chronic Low-back Pain
    1. Other: non interventional
    MeSH:Back Pain Low Back Pain Pain
    HPO:Back pain Low back pain Pain

    Primary Outcomes

    Description: Proportion of subjects having a significant change in their low back pain intensity during confinement, defined by the items "much worse" and "moderately worse", or "much improved" and "moderately improved" respectively.The meaning of this significant change (worsening or improvement) will also be described.

    Measure: Impact of confinement on the low back pain intensity

    Time: at inclusion

    Secondary Outcomes

    Description: Change in low back pain intensity between before and during confinement evaluated by a numerical pain scale rated from 0 to 10 (0 = no pain ; 10 = worst imaginable pain). Confinement conditions (alone or in a group, space, etc.) and the practice of physical and sporting activities during confinement (weekly duration, etc.)

    Measure: Correlation between confinement conditions and low back pain intensity

    Time: at inclusion

    Description: Disability measured by the "incapacity" sub-score of the "Core Outcome Measures Index" (COMI) questionnaire

    Measure: Correlation between confinement conditions and disability related to low back pain

    Time: at inclusion

    Description: Occurrence of a SARS-CoV-2 infection and its level of severity (confirmed diagnosis, few or no symptoms, symptoms severely limiting daily activities, hospitalization in a conventional service or in intensive care)

    Measure: Correlation between infection with the new SARS-CoV-2 coronavirus and change in low back pain intensity

    Time: at inclusion

    Description: Quality of life and levels of anxiety and depression evaluated with the COMI-AD sub-score (modified version of the COMI integrating the state of psychological health);

    Measure: Correlation between confinement conditions and quality of life as well as psychological health

    Time: at inclusion

    Description: Use of care, drug consumption and psychoactive substances (tobacco, cannabis, alcohol, anxiolytics) for low back pain

    Measure: Impact of confinement on the use of care and the consumption of medication and psychoactive substances for low back pain

    Time: at inclusion

    Description: Modalities of the the ocupational activity continuation (continuation of the activity, evolution of the working time, telework and modalities of establishment)

    Measure: Correlation between working conditions and / or teleworking and low back pain intensity

    Time: at inclusion

    Description: Experience of confinement. Socio-economic characteristics of the participants (age, sex, department, job and socio-professional category).

    Measure: Correlation between socio-economic factors and modalities as well as the experience of confinement

    Time: at inclusion

    HPO Nodes


    Data processed on September 26, 2020.

    An HTML report was created for each of the unique drugs, MeSH, and HPO terms associated with COVID-19 clinical trials. Each report contains a list of either the drug, the MeSH terms, or the HPO terms. All of the terms in a category are displayed on the left-hand side of the report to enable easy navigation, and the reports contain a list of correlated drugs, MeSH, and HPO terms. Further, all reports contain the details of the clinical trials in which the term is referenced. Every clinical trial report shows the mapped HPO and MeSH terms, which are also hyperlinked. Related HPO terms, with their associated genes, protein mutations, and SNPs are also referenced in the report.

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