HOPE Consortium Trial to Reduce Pain and Opioid Use in Hemodialysis

Summary

HOPE is a randomized clinical trial that will evaluate approaches to reducing pain and opioid use among patients with chronic pain who are receiving maintenance hemodialysis for end-stage renal disease. The hypothesis is that pain coping skills training will be effective at reducing pain and opioid use, and that buprenorphine will be acceptable and tolerable as an approach to managing physical dependence on opioids in this patient population.

Conditions

• End Stage Renal Disease
• Chronic Pain
• Opioid Dependence

Interventions

BEHAVIORAL

Pain Coping Skills Training (PCST)

The PCST intervention will focus primarily on reducing pain interference in daily activities and improving pain self-management skills. For participants with recent or current opioid use, the PCST intervention will include motivational interviewing aimed at reducing opioid use. During Weeks 1 - 12 the PCST will be delivered by coaches via telehealth (video). During Weeks 13 - 24, the Interactive Voice Response (IVR) will be delivered via telephone. The telehealth component will consist of weekly sessions, each lasting 45-50 minutes. The IVR content, intended to enhance and sustain the effects of the coach-led session, will be delivered with daily telephone interactions, each lasting approximately 5 minutes. Both components of the intervention will be available in English and Spanish.

DRUG

Buprenorphine

At Week 24, participants who meet the eligibility criteria for the buprenorphine intervention will be encouraged to switch from their current full agonist opioid medication to the partial opioid agonist, buprenorphine. Participants who switch to Buprenorphine will be provided with individualized buprenorphine treatment recommendations. Individualized buprenorphine treatment recommendations will be made by the study buprenorphine physician based on current opioid use and other relevant factors. Participants who do not meet the Phase 2 eligibility criteria will not be offered buprenorphine. All participants will continue to be followed from Week 24 until Week 36 for ascertainment of pain, opioid use, and other outcomes to address durability of the effects of PCST, and, for those who switch to buprenorphine, to assess buprenorphine acceptability, tolerability, and efficacy as exploratory outcomes.

Sponsors & Collaborators

• Hennepin Health Care

  collaborator UNKNOWN

• New York University

  collaborator OTHER

• Massachusetts General Hospital

  collaborator OTHER

• University of Illinois at Chicago

  collaborator OTHER

• University of Pittsburgh

  collaborator OTHER

• University of Washington

  collaborator OTHER

• University of New Mexico

  collaborator OTHER

• Rogosin Institute

  collaborator UNKNOWN

• Vanderbilt University Medical Center

  collaborator OTHER

• West Virginia University

  collaborator OTHER

• Yale University

  collaborator OTHER

• Durham VA Health Care System

  collaborator FED

• VA Portland Healthcare System

  collaborator UNKNOWN

• West Haven VA Medical Center

  collaborator UNKNOWN

• University of Pennsylvania

  collaborator OTHER

• Dallas VA Medical Center

  collaborator FED

• VA New York Harbor Healthcare System

  collaborator FED

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

  lead NIH

Principal Investigators

• Laura Dember, MD · University of Pennsylvania

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-01-03

Primary Completion

2023-12-21

Completion

2024-05-31

FDA Drug

Yes

Countries

• United States

Study Locations