The Pain Course: 12- and 24-month outcomes from a randomized controlled trial of an Internet-delivered pain management program provided with different levels of clinician support

Blake F. Dear*, Milena Gandy, Eyal Karin, Rhiannon Fogliati, Vincent J. Fogliati, Lauren G. Staples, Bethany M. Wootton, Louise Sharpe, Nickolai Titov

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)

    Abstract

    Little is known about the long-term outcomes of emerging Internet-delivered pain management programs. The current study reports the 12- and 24-month follow-up data from a randomized controlled trial (n = 490) of an Internet-delivered pain management program, the Pain Course. The initial results of the trial to the 3-month follow-up have been reported elsewhere. There were significant improvements in disability, depression, anxiety, and pain levels across 3 treatment groups receiving different levels of clinician support compared with a treatment as the usual control. No marked or significant differences were found between the treatment groups either after treatment or at the 3-month follow-up. The current study obtained long-term follow-up data from 78% and 79% of participants (n = 397) at the 12-month and 24-month follow-up marks, respectively. Clinically significant decreases (average percent reduction; Cohen's d effect sizes) were maintained at the 12- and 24-month follow-ups for disability (average reduction ≥27%; d ≥.67), depression (average reduction ≥36%; d ≥.80), anxiety (average reduction ≥38%; d ≥.66), and average pain levels (average reduction ≥21%; d ≥.67). No marked or consistent differences were found among the 3 treatment groups. These findings suggest that the outcomes of Internet-delivered programs may be maintained over the long term. Perspective: This article presents the long-term outcome data of an established Internet-delivered pain management program for adults with chronic pain. The clinical improvements observed during the program were found to be maintained at the 12- and 24-month follow-up marks. This finding indicates that these programs can have lasting clinical effects.

    Original languageEnglish
    Pages (from-to)1491-1503
    Number of pages13
    JournalJournal of Pain
    Volume19
    Issue number12
    DOIs
    Publication statusPublished - Dec 2018

    Keywords

    • chronic pain
    • depression
    • anxiety
    • randomized controlled trial
    • long-term outcomes
    • Internet
    • online
    • cognitive-behavioral therapy

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