短信服务提示在基于互联网的慢性疼痛认知行为疗法中进行技能练习——它们可行且有效吗？

Short message service prompts for skills practice in Internet-delivered cognitive behaviour therapy for chronic pain - are they feasible and effective?

作者信息

Gandy M, Fogliati V J, Terides M D, Johnston L, Nicholson Perry K, Newall C, Titov N, Dear B F

机构信息

eCentreClinic, Department of Psychology, Macquarie University, Sydney, NSW, Australia.

Australian College of Applied Psychology, Sydney, NSW, Australia.

出版信息

Eur J Pain. 2016 Sep;20(8):1288-98. doi: 10.1002/ejp.853. Epub 2016 Apr 13.

DOI:10.1002/ejp.853

PMID:27072189

Abstract

BACKGROUND

Patients face numerous challenges adopting skills taught within pain self-management programmes. The present study reports the acceptability and preliminary outcomes of supplementing an Internet-delivered cognitive behavioural therapy (iCBT) course for chronic pain, the Pain Course, with brief automated short message service (SMS) prompts that encourage skills practice.

METHODS

Participants were recruited from the Waitlist Control Group of a large randomized controlled trial and provided access to the Pain Course over 8 weeks, with the addition of SMS prompts. Fifteen SMS prompts were created to encourage the use of self-management skills during the course. Participants were sent one random SMS prompt each business day. The acceptability of the SMS was assessed and clinical outcomes of participants who received prompts (n = 56) compared with a historical group who previously received the course without prompts (n = 139).

RESULTS

SMS prompts were rated highly with 85% reporting them to be very helpful or helpful and that they would recommend them to others. Clinical improvements for those receiving SMS, at post-treatment and 3-month follow-up (disability, d = 0.44; 0.58; anxiety d = 0.50; 0.51; depression, d = 0.78; 0.79 and average pain d = 0.49; 0.54), were consistent with participant who had received the course previously without SMS (ps >0.05).

CONCLUSIONS

Brief automated SMS prompts were an acceptable adjunct to iCBT for chronic pain but did not result in any additional clinical benefit. Further research is needed to systematically evaluate the potential of SMS prompts to increase skills practice and facilitate treatment outcomes. WHAT DOES THIS STUDY ADD?: Automated short message service (SMS) messages are an acceptable means of prompting skills practice during iCBT for chronic pain. SMS prompts did not improve clinical outcomes of an established clinician-supported iCBT programme.

摘要

背景

患者在采用疼痛自我管理项目中所教授的技能时面临诸多挑战。本研究报告了为慢性疼痛的互联网认知行为疗法（iCBT）课程“疼痛课程”补充简短自动短信服务（SMS）提示以鼓励技能练习的可接受性和初步结果。

方法

参与者从一项大型随机对照试验的候补对照组中招募，并在8周内获得“疼痛课程”，同时增加短信提示。创建了15条短信提示以鼓励在课程期间使用自我管理技能。每个工作日向参与者发送一条随机短信提示。评估了短信的可接受性，并将收到提示的参与者（n = 56）的临床结果与之前接受过无提示课程的历史组（n = 139）进行了比较。

结果

短信提示的评分很高，85%的人表示它们非常有帮助或有帮助，并且会向他人推荐。接受短信提示的人在治疗后和3个月随访时的临床改善（残疾，d = 0.44；0.58；焦虑，d = 0.50；0.51；抑郁，d = 0.78；0.79；平均疼痛，d = 0.49；0.54）与之前接受过无短信课程的参与者一致（p值>0.05）。

结论

简短自动短信提示是慢性疼痛iCBT的可接受辅助手段，但未带来任何额外的临床益处。需要进一步研究以系统评估短信提示在增加技能练习和促进治疗结果方面的潜力。本研究补充了什么？：自动短信服务（SMS）消息是在慢性疼痛iCBT期间提示技能练习的可接受方式。短信提示并未改善既定的临床医生支持的iCBT项目的临床结果。