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 Researchers tested a series of web-based pain management tutorials
on a group of adults who had been suffering symptoms for more than
six months. Regardless of how much contact the patients had with
clinicians, they all experienced significant reductions in
disability, anxiety and average pain levels at the end of the eight
week experiment as well as three months down the line.
“While face-to-face pain management programs are important, many
adults with chronic pain can benefit from programs delivered via the
internet, and many of them do not need a lot of contact with a
clinician in order to benefit,” lead study author Blake Dear, a
psychology researcher at Macquarie University in New South Wales,
said by email.
Dear and colleagues recruited patients online, then whittled the
group down to 490 adults who had seen a doctor to assess their pain
within the past three months, had no psychotic illnesses or severe
depression and had regular access to a computer and the internet.
Participants were divided into one of three treatment groups to
receive the web-based tutorials (http://bit.ly/1SQb0uh) along with
regular contact with clinicians during the study, optional contact
with providers or no contact. A fourth control group was told they
were wait-listed for the online program and carried on their usual
treatment with their doctors.
Patients in the regular contact group were required to have weekly
phone or email conversations with clinicians trained in psychology,
while people in the optional contact group were told this was
available if they wanted to do it and the non-contact group was told
clinicians were only available if they had technical difficulties or
a mental health emergency.
The regular contact group had an average of 68 minutes of contact
with clinicians over the eight-week treatment period, compared with
13 minutes for the optional contact group and about 5 minutes for
the group with only emergency contact.
During that time, people in the treatment groups also had five
web-based lessons that focused on pain management using cognitive
behavior therapy techniques.
At the end of the eight weeks, patients in the treatment groups had
average reductions of at least 18 percent in disability, 32 percent
for anxiety, 36 percent for depression and 12 percent in typical
pain levels.
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These improvements were sustained or even improved after three
months, and there were no significant differences between the
intervention groups based on how much contact people had with
clinicians.
In addition, people in the treatment groups had significantly
greater reductions in disability, depression and anxiety than the
patients wait-listed for the online courses.
One limitation of the study, the researchers acknowledge in the
journal Pain, is that the study didn’t examine what therapies people
received in the control group getting “treatment as usual,” which
makes it impossible to know if people in that group would have
recovered without any treatment.
Also, because all of the study participants asked to join a
web-based symptom management program, it’s possible the results
would be different among people not seeking out this type of care,
the authors note.
It’s also possible that, given more than just the three months of
follow up, more differences would emerge between the treatment
groups, said Christine Rini, a behavioral health researcher at the
University of North Carolina Chapel Hill.
“More broadly speaking, it may be that the most critical information
that patients get from doctors working with an internet-based pain
management program is communicated relatively quickly, and that
additional contact does not really matter,” Rini, who wasn’t
involved in the study, said by email.
SOURCE: http://bit.ly/1FF5S2O Pain, online May 30, 2015.
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