Al Sharaa Haya, Bartels Sara Laureen, Taygar Afra S, Engman Linnéa, Petersson Suzanne, Flink Ida, Boersma Katja, McCracken Lance M, Simons Laura, Vlaeyen Johan W S, Onghena Patrick, Wicksell Rikard K
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Pain Clinic, Capio St. Göran's Hospital, Stockholm, Sweden.
Eur J Pain. 2025 Nov;29(10):e70128. doi: 10.1002/ejp.70128.
Chronic pain affects 20%-30% of the population worldwide, leading to significant distress, disability and financial burden. Pain management strategies focusing on pain reduction have shown limited effects on functioning; however, behavioural treatments aimed at enhancing resilience have demonstrated strong empirical support. Digital solutions offer new opportunities for delivering evidence-based treatments, but evaluation at the individual level is needed. The aim of this study is to examine individual-level treatment effects of a digital behavioural treatment for chronic pain in a heterogeneous sample.
A study with a single-case experimental design (SCED) was conducted with participants (N = 11) experiencing chronic pain (> 3 months) recruited through healthcare. Participants were randomised at baseline (5-10-day A-phase) and completed a 6-module digital treatment based on learning theory and well-established theories applied to chronic pain (6-8-week B-phase), with weekly therapist contact. Digital diaries, prompted twice daily, tracked psychological flexibility and acceptance, pain-related functioning, pain intensity and well-being. Data were analysed using visual analysis and effect size calculations.
N = 11 enrolled and data from n = 10 were analysed (n = 1 refused digital diary, n = 2 partial completers, n = 8 full completers). Pain profiles varied (e.g., chronic migraine, fibromyalgia, lower back pain, etc.). Several participants benefited from the treatment, though results varied across individuals and across outcomes.
The digital behavioural treatment showed promise in addressing diverse pain profiles and associated functioning. The variability in responses highlights the benefit of using SCED to explore individual-level effects, thus offering a methodological proof-of-concept. Findings support further development, including tailoring to match individual needs.
This proof-of-concept study provides support for the utility of digital behavioural interventions and individual-level evaluation of treatment effects, highlighting the potential of personalised pain treatments. The findings contribute to the growing body of support for digital solutions as effective and accessible approaches to improve functioning and resilience for people with diverse pain experiences.
慢性疼痛影响着全球20%-30%的人口，会导致严重的痛苦、残疾和经济负担。专注于减轻疼痛的疼痛管理策略对功能的改善效果有限；然而，旨在增强恢复力的行为治疗已获得强有力的实证支持。数字解决方案为提供循证治疗带来了新机遇，但需要在个体层面进行评估。本研究的目的是在一个异质性样本中检验一种针对慢性疼痛的数字行为治疗的个体层面治疗效果。
对通过医疗保健机构招募的患有慢性疼痛（超过3个月）的参与者（N = 11）进行了一项单病例实验设计（SCED）研究。参与者在基线期（5-10天的A阶段）被随机分组，并基于学习理论以及应用于慢性疼痛的成熟理论完成了一个6模块的数字治疗（6-8周的B阶段），治疗期间治疗师每周进行一次联系。每天提示两次的数字日记记录了心理灵活性和接纳度、与疼痛相关的功能、疼痛强度和幸福感。使用视觉分析和效应量计算对数据进行分析。
11人登记参与研究，分析了10人的数据（1人拒绝使用数字日记，2人部分完成，8人完全完成）。疼痛情况各不相同（例如，慢性偏头痛、纤维肌痛、下背痛等）。尽管个体和结果的结果各不相同，但有几位参与者从治疗中受益。
数字行为治疗在解决多种疼痛情况及相关功能方面显示出前景。反应的变异性凸显了使用单病例实验设计来探索个体层面效果的益处，从而提供了一种方法学概念验证。研究结果支持进一步开发，包括根据个体需求进行调整。
这项概念验证研究为数字行为干预的效用以及治疗效果的个体层面评估提供了支持，凸显了个性化疼痛治疗的潜力。这些发现为支持数字解决方案作为改善不同疼痛经历人群的功能和恢复力的有效且可及的方法的证据不断增加做出了贡献。
