title: The Pain Course: a randomised controlled trial examining an internet-delivered pain management program when provided with different levels of clinician support.
abstract: The present study evaluated an internet-delivered pain management program, the Pain Course, when provided with different levels of clinician support. Participants (n = 490) were randomised to 1 of 4 groups: (1) Regular Contact (n = 143), (2) Optional Contact (n = 141), (3) No Contact (n = 131), and (4) a treatment-as-usual Waitlist Control Group (n = 75). The treatment program was based on the principles of cognitive behaviour therapy and comprised 5 internet-delivered lessons provided over 8 weeks. The 3 Treatment Groups reported significant improvements (between-group Cohen's d; avg. reduction) in disability (ds ≥ 0.50; avg. reduction ≥ 18%), anxiety (ds ≥ 0.44; avg. reduction ≥ 32%), depression (ds ≥ 0.73; avg. reduction ≥ 36%), and average pain (ds ≥ 0.30; avg. reduction ≥ 12%) immediately posttreatment, which were sustained at or further improved to 3-month follow-up. High treatment completion rates and levels of satisfaction were reported, and no marked or consistent differences were observed between the Treatment Groups. The mean clinician time per participant was 67.69 minutes (SD = 33.50), 12.85 minutes (SD = 24.61), and 5.44 minutes (SD = 12.38) for those receiving regular contact, the option of contact, and no clinical contact, respectively. These results highlight the very significant public health potential of carefully designed and administered internet-delivered pain management programs and indicate that these programs can be successfully administered with several levels of clinical support.
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia Departments of Medicine and Psychology, University of Tasmania, Hobart, Australia Australian College of Applied Psychology, Sydney, Australia Department of Psychology, University of Sydney, Sydney, Australia Pain Management Research Institute, Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Blake F
authors.initials: BF
authors.lastname: Dear
authors.forename: Milena
authors.initials: M
authors.lastname: Gandy
authors.forename: Eyal
authors.initials: E
authors.lastname: Karin
authors.forename: Lauren G
authors.initials: LG
authors.lastname: Staples
authors.forename: Luke
authors.initials: L
authors.lastname: Johnston
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Fogliati
authors.forename: Bethany M
authors.initials: BM
authors.lastname: Wootton
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Terides
authors.forename: Rony
authors.initials: R
authors.lastname: Kayrouz
authors.forename: Kathryn Nicholson
authors.initials: KN
authors.lastname: Perry
authors.forename: Louise
authors.initials: L
authors.lastname: Sharpe
authors.forename: Michael K
authors.initials: MK
authors.lastname: Nicholas
authors.forename: Nickolai
authors.initials: N
authors.lastname: Titov
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003695:Delivery of Health Care; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010349:Patient Compliance; D010698:Phobic Disorders / Q000209:etiology / Q000628:therapy; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult