Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 14, 2023
Date Accepted: Jun 20, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Short-term findings from a randomized controlled trial testing EPIO – a digital self-management program for people living with chronic pain
ABSTRACT
Background:
Chronic pain conditions implicate numerous physical and psychological challenges, and while psychosocial self-management interventions can be of benefit for people living with chronic pain, such in-person treatment is not always accessible. Digital self-management approaches could improve this disparity, potentially bolstering outreach and providing easy, relatively low-cost access to pain self-management interventions.
Objective:
The current randomized controlled trial aimed to evaluate the short-term efficacy of EPIO, a digital self-management intervention for people living with chronic pain.
Methods:
Patients (N=266) were randomly assigned to the EPIO intervention (n=132) or a care-as-usual control group (n=134). Outcome measures included pain interference (BPI; primary outcome measure), anxiety and depression (HADS), self-regulatory fatigue (SRF-18), health-related quality of life (SF-36/RAND-36), pain catastrophizing (PCS), and pain acceptance (CPAQ). Linear regression models employed change scores as dependent variables.
Results:
Participants were primarily women (81%), median age of 49 (range 22-78), with a variety of pain conditions. Analyses (n=229) after 3 months revealed no statistical significance for the primary outcome of pain interference, but significant reductions in the secondary outcomes of depression (mean difference (MD) -.90, P=.034) and self-regulatory fatigue (MD -2.76, P=.008) in favor of the intervention group. No other statistically significant changes were observed at 3 months. Participants described EPIO as useful (ie, totally agree or agree; 95/109, 87%) and easy to use (101/109, 93%), with easily understandable exercises (106/109, 97%).
Conclusions:
Evidence-informed, user-centered digital pain self-management interventions such as EPIO may have the potential to effectively support self-management and improve psychological functioning in the form of reduced symptoms of depression and improved capacity to regulate thoughts, feelings, and behavior for people living with chronic pain. Clinical Trial: ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104
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