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Non-pharmacological treatments are needed to dually address pain and opioid risks. The purpose of the Mobile and Online-Based Interventions to Lessen Pain (MOBILE Relief) study is to compare a one-session, video-based, on-demand digital pain relief skills intervention for chronic pain (\u2018Empowered Relief\u2019 (ER); tailored to people at risk for opioid misuse or with opioid misuse\/OUD) to a one-session digital health education intervention (\u2018Living Better\u2019; no pain management skills).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>MOBILE Relief is an international online randomised controlled clinical trial. Study participants are adults with chronic, non-cancer pain (\u22656 months) with daily pain intensity \u22653\/10, taking \u226510 morphine equivalent daily dose and score \u22656 on the Current Opioid Misuse Measure. Participants are recruited through clinician referrals and clinic advertisements. Study procedures include electronic eligibility screening, informed consent, automated 1:1 randomisation to the treatment group, baseline measures, receipt of assigned digital treatment and six post-treatment surveys spanning 3\u2009months. Study staff will call participants at baseline and 1-month and 3\u2009months post-treatment to verify the opioid prescription. The main statistical analyses will include analysis of covariance and mixed effects model for repeated measurements regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes<\/jats:title>\n                    <jats:p>Primary outcomes are self-reported pain catastrophising, pain intensity, pain interference, opioid craving and opioid misuse at 1-month and 3\u2009months post-treatment. We will determine the feasibility of ER (\u226550% participant engagement, \u226570% treatment appraisal ratings). We hypothesise the ER group will be superior to the Living Better group in the reduction of multiprimary pain outcomes at 1-month post-treatment and opioid outcomes at 1-month and 3\u2009months post-treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol was approved by the Stanford University School of Medicine Institutional Review Board (IRB 61643). We will publish results in peer-reviewed journals; National Institute of Drug Abuse (funder) and MOBILE Relief participants will receive result summaries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05152134\">NCT05152134<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086889","type":"journal-article","created":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T12:41:38Z","timestamp":1723207298000},"page":"e086889","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Protocol for a randomised trial of a self-directed digital pain management intervention (Empowered Relief) tailored to adults with chronic pain and prescription opioid misuse\/disorder: the MOBILE Relief study"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct05152134","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04546685","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05057988","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05980104","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05934435","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05998369","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5821-3733","authenticated-orcid":false,"given":"Karlyn A","family":"Edwards","sequence":"first","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paige","family":"Palenski","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luzmercy","family":"Perez","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dokyoung Sophia","family":"You","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maisa S","family":"Ziadni","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne","family":"Jung","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Adair","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Tian","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean C","family":"Mackey","sequence":"additional","affiliation":[{"name":"Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth D","family":"Darnall","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"2025121604210660000_14.8.e086889.1","unstructured":"World drug report 2023. 2023. 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