Abstract
Chronic pain is common after spinal cord injury (SCI) and dedicated SCI cognitive behavioural therapy pain management programmes (CBT‐PMPs) have a growing evidence‐base to support their uptake clinically. The development of internet‐delivered treatment options may overcome barriers to the access and uptake of centre‐based programmes. This study examines such an approach on quality of lie (QoL), pain, mood and sleep.
Methods
Adults with SCI pain (>3 months) were recruited and randomly assigned to the intervention or control group. The intervention comprised a six module CBT‐PMP delivered once weekly. A blinded assessor determined changes in self‐reported outcome measures post intervention and at three months. Linear Mixed Models and effect sizes based on changes between groups were reported. Significance was set P<0.05.
Results
The recruitment rate was 32% (intervention n=35, control n=34), and the drop‐out rate at three months was 26%. On average participants accessed 3 (sd 2.1) of 6 modules. Whilst no difference in QoL was reported, a significant group*time interaction was found for NRS of current pain (Χ2=8.22, p=0.016) worst pain (Χ2=11.20, p=0.004) and Brief Pain Inventory (interference) (Χ2= 6.924, p= 0.031). Moderate to large effect sizes favouring the intervention were demonstrated at each timepoint for the pain metrics (Cohen's d: 0.38‐0.84). At three month follow up 48% of the intervention group rated themselves improved or very much improved.
Conclusions
This study demonstrates the potential of an internet delivered SCI specific CBT‐PMP in reporting significant statistical and clinical benefit in pain intensity and interference. Strategies to improve engagement are needed.
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from Wiley: European Journal of Pain: Table of Contents http://bit.ly/2Iwp68e
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