aeCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia bAustralian College of Applied Psychology, Sydney, Australia cDepartment of Psychology, University of Sydney, Sydney, Australia dPain Management Research Institute, Northern Clinical School, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia.
Pain. 2017 Jul;158(7):1289-1301. doi: 10.1097/j.pain.0000000000000916.
This study compared a remote-delivered pain management program, the Pain Course, when delivered in online and workbook formats. Participants (n = 178) were randomised into 2 groups: (1) an Internet Group (n = 84) who were provided with secure accounts to the program in an online format; or (2) a Workbook Group (n = 94) who were mailed workbook versions of the program. The content of both programs was identical and comprised 5 core lessons, which participants were encouraged to work through over an 8-week period, according to a prescribed timetable. All participants were provided with weekly contact with a clinical psychologist through email and telephone throughout the program. The overall findings suggest that the workbook format was no less effective or acceptable than the validated online format. Significant improvements (avg. improvement; Internet Group vs Workbook Group) in levels of disability (PDI: 16% vs 24%; RMDQ: 12% vs 15%), anxiety (GAD-7: 36% vs 26%), and depression (PHQ-9: 36% vs 36%) were observed in both groups immediately posttreatment. Further improvements were observed in disability levels to 3-month follow-up, and improvements across the other primary outcomes were maintained until 12-month follow-up. High treatment completion rates and levels of satisfaction were reported in both groups, and both groups required a similarly small amount of clinician contact per participant (M = 74.85 minutes; SD = 41.03). These results highlight the public health potential of remote-delivered pain management programs, delivered in either workbook or online formats, as methods of increasing access to pain management.
本研究比较了远程提供的疼痛管理课程,即疼痛课程,该课程以在线和工作簿格式提供。参与者(n=178)被随机分为 2 组:(1)互联网组(n=84),他们被提供了安全的在线课程账户;或(2)工作簿组(n=94),他们收到了课程的工作簿版本。两个课程的内容完全相同,包含 5 个核心课程,参与者被鼓励在 8 周内按照规定的时间表完成课程。所有参与者都在整个课程期间通过电子邮件和电话每周与临床心理学家联系。总体结果表明,工作簿格式与经过验证的在线格式一样有效或可接受。治疗后立即观察到两组的残疾程度(PDI:16%比 24%;RMDQ:12%比 15%)、焦虑(GAD-7:36%比 26%)和抑郁(PHQ-9:36%比 36%)都有显著改善。在 3 个月的随访中,残疾程度进一步改善,其他主要结果的改善一直持续到 12 个月的随访。两组均报告了较高的治疗完成率和满意度,并且两组每个参与者所需的临床医生联系时间相似(M=74.85 分钟;SD=41.03)。这些结果突出了远程提供的疼痛管理课程的公共卫生潜力,无论是以工作簿还是在线格式提供,都可以作为增加疼痛管理机会的方法。