Individual-Level Effects of a Digital Behavioural Treatment for Chronic Pain: Proof-of-Concept of a Single-Case Experimental Design Study

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-09-18 DOI:10.1002/ejp.70128

Haya Al Sharaa, Sara Laureen Bartels, Afra S. Taygar, Linnéa Engman, Suzanne Petersson, Ida Flink, Katja Boersma, Lance M. McCracken, Laura Simons, Johan W. S. Vlaeyen, Patrick Onghena, Rikard K. Wicksell

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引用次数: 0

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Significance Statement

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.

Abstract Image

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数字行为治疗慢性疼痛的个体水平效应：单例实验设计研究的概念验证。

背景：慢性疼痛影响全世界20%-30%的人口，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影响有限；然而，旨在增强弹性的行为治疗已经证明了强有力的经验支持。数字解决方案为提供循证治疗提供了新的机会，但需要在个人层面进行评估。本研究的目的是在异质性样本中检查数字行为治疗慢性疼痛的个人水平治疗效果。方法：采用单病例实验设计（SCED），通过医疗机构招募慢性疼痛患者（N = 11）（3个月）。参与者在基线（5-10天a期）随机分配，并完成基于学习理论和已建立的慢性疼痛理论（6-8周b期）的6个模块的数字治疗，每周与治疗师联系。每天两次的电子日记记录了心理灵活性和接受度、疼痛相关功能、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。结果：N = 11人入组，N = 10人的数据被分析（N = 1人拒绝电子日记，N = 2人部分完成，N = 8人完全完成）。疼痛特征各不相同（例如，慢性偏头痛，纤维肌痛，腰痛等）。一些参与者从治疗中受益，尽管结果因个体和结果而异。结论：数字行为治疗在解决不同的疼痛特征和相关功能方面显示出希望。反应的可变性突出了使用SCED探索个人层面影响的好处，从而提供了一种方法上的概念证明。研究结果支持进一步的开发，包括根据个人需求进行定制。意义声明：这项概念验证研究为数字行为干预和个人层面的治疗效果评估提供了支持，强调了个性化疼痛治疗的潜力。这些发现有助于越来越多的人支持数字解决方案作为有效和可访问的方法，以改善不同疼痛经历的人的功能和恢复力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.