Dear Blake F, Courtney Catherine, Khor Kok Eng, McDonald Sarah, Ricciardi Tahlia, Gandy Milena, Fogliati Vincent J, Titov Nick
Department of Psychology, Macquarie University.
Department of Pain Management, Prince of Wales Hospital, Sydney, Australia.
Clin J Pain. 2018 Jun;34(6):505-514. doi: 10.1097/AJP.0000000000000565.
This study examined the acceptability and preliminary outcomes of an internet-delivered pain management program, the Pain Course, when offered by a specialist pain management clinic in a large public hospital.
A single-group feasibility open-trial design was used and 39 patients participated in the program, which ran for 8 weeks. Participants were supported through the program with weekly contact from a Clinical Psychologist at the clinic.
All participants provided data at posttreatment and >90% of participants completed all 5 lessons of the course. High levels of satisfaction were observed and relatively little clinician time (M=71.99 min/participant; SD=32.82 min) was required to support patients through the program. Preliminary evidence of clinical improvements in depression symptoms (avg. improvement=38%; Cohen d=0.74), but not disability levels or anxiety symptoms, was observed in the overall sample. However, evidence of improvements was observed across all the primary outcomes among patients who had clinical levels of difficulties with disability (n=20; avg. improvement=11%; Cohen d=0.64), depression (n=17; avg. improvement=35%; Cohen d=1.24) and anxiety (n=8; avg. improvement=29%; Cohen d=0.57).
These findings highlight the potential value of internet-delivered programs when provided by specialist pain management clinics as a part of their services and the value of larger scale studies in this area.
本研究调查了一家大型公立医院的专科疼痛管理诊所提供的互联网疼痛管理项目“疼痛课程”的可接受性和初步效果。
采用单组可行性开放试验设计,39名患者参与了为期8周的项目。在项目进行过程中,诊所的临床心理学家每周与参与者联系,为他们提供支持。
所有参与者在治疗后都提供了数据,超过90%的参与者完成了该课程的全部5个课程。观察到参与者满意度较高,且在项目过程中支持患者所需的临床医生时间相对较少(平均为71.99分钟/参与者;标准差为32.82分钟)。在总体样本中,观察到抑郁症状有临床改善的初步证据(平均改善率为38%;Cohen d=0.74),但残疾水平或焦虑症状没有改善。然而,在残疾方面存在临床困难水平的患者(n=20;平均改善率为11%;Cohen d=0.64)、抑郁(n=17;平均改善率为35%;Cohen d=1.24)和焦虑(n=8;平均改善率为29%;Cohen d=0.57)的所有主要结局中均观察到改善的证据。
这些发现凸显了专科疼痛管理诊所提供互联网项目作为其服务一部分的潜在价值,以及该领域大规模研究的价值。