{"title":"随机对照试验,调查多模式移动应用治疗慢性疼痛的效果。","authors":"Cynthia J Thomson, Hanna Pahl, Luisa V Giles","doi":"10.1080/24740527.2024.2352399","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Until recently, treatments for chronic pain commonly relied on in-person interventions, and despite more hybrid care options today, capacity for delivery remains challenged. Digital programs focusing on the psychosocial aspects of pain may provide low-barrier alternatives.</p><p><strong>Aims: </strong>Through a randomized controlled trial, we investigated the effectiveness of a multimodal mobile application.</p><p><strong>Methods: </strong>Participants (<i>n = </i>198; 82% women, mean age = 46.7 [13.1] years; mean pain duration 13.6 [11.2] years) with nonmalignant chronic pain were randomized to either a 6-week intervention (<i>n</i> = 98) or a wait-listed usual care group (<i>n</i> = 100). The intervention involved regular engagement with a user-guided mobile application (Curable Inc.) informed by the biopsychosocial model of pain that included pain education, meditation, cognitive behavioral therapy, and expressive writing. The co-primary outcomes were pain severity and interference at 6 weeks.</p><p><strong>Results: </strong>We observed significant improvements in the intervention group compared to the control group with estimated changes of -0.67 (95% confidence interval [CI] -1.04 to -0.29, <i>P</i> < .001, <i>d</i> = 0.43) and -0.60 (95% CI -1.18 to -0.03, <i>P</i> = .04, <i>d</i> = 0.27) for pain severity and interference, respectively. There were significant improvements across secondary outcomes (Patient-Reported Outcome Measurement Information System pain interference; pain catastrophizing; anxiety, depression; stress). Frequency of app use was correlated with improved pain interference (<i>P</i> < .001) and pain catastrophizing <i>(P</i> = 0.018), and changes from baseline persisted in the intervention group at 12 weeks (<i>P</i> < .05).</p><p><strong>Conclusions: </strong>A short-term mobile app intervention resulted in significant improvements across physical and mental health outcomes compared to wait-listed usual care.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"8 1","pages":"2352399"},"PeriodicalIF":2.0000,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340744/pdf/","citationCount":"0","resultStr":"{\"title\":\"Randomized controlled trial investigating the effectiveness of a multimodal mobile application for the treatment of chronic pain.\",\"authors\":\"Cynthia J Thomson, Hanna Pahl, Luisa V Giles\",\"doi\":\"10.1080/24740527.2024.2352399\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Until recently, treatments for chronic pain commonly relied on in-person interventions, and despite more hybrid care options today, capacity for delivery remains challenged. Digital programs focusing on the psychosocial aspects of pain may provide low-barrier alternatives.</p><p><strong>Aims: </strong>Through a randomized controlled trial, we investigated the effectiveness of a multimodal mobile application.</p><p><strong>Methods: </strong>Participants (<i>n = </i>198; 82% women, mean age = 46.7 [13.1] years; mean pain duration 13.6 [11.2] years) with nonmalignant chronic pain were randomized to either a 6-week intervention (<i>n</i> = 98) or a wait-listed usual care group (<i>n</i> = 100). The intervention involved regular engagement with a user-guided mobile application (Curable Inc.) informed by the biopsychosocial model of pain that included pain education, meditation, cognitive behavioral therapy, and expressive writing. The co-primary outcomes were pain severity and interference at 6 weeks.</p><p><strong>Results: </strong>We observed significant improvements in the intervention group compared to the control group with estimated changes of -0.67 (95% confidence interval [CI] -1.04 to -0.29, <i>P</i> < .001, <i>d</i> = 0.43) and -0.60 (95% CI -1.18 to -0.03, <i>P</i> = .04, <i>d</i> = 0.27) for pain severity and interference, respectively. There were significant improvements across secondary outcomes (Patient-Reported Outcome Measurement Information System pain interference; pain catastrophizing; anxiety, depression; stress). Frequency of app use was correlated with improved pain interference (<i>P</i> < .001) and pain catastrophizing <i>(P</i> = 0.018), and changes from baseline persisted in the intervention group at 12 weeks (<i>P</i> < .05).</p><p><strong>Conclusions: </strong>A short-term mobile app intervention resulted in significant improvements across physical and mental health outcomes compared to wait-listed usual care.</p>\",\"PeriodicalId\":53214,\"journal\":{\"name\":\"Canadian Journal of Pain-Revue Canadienne de la Douleur\",\"volume\":\"8 1\",\"pages\":\"2352399\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-08-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340744/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Journal of Pain-Revue Canadienne de la Douleur\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/24740527.2024.2352399\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Pain-Revue Canadienne de la Douleur","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/24740527.2024.2352399","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Randomized controlled trial investigating the effectiveness of a multimodal mobile application for the treatment of chronic pain.
Background: Until recently, treatments for chronic pain commonly relied on in-person interventions, and despite more hybrid care options today, capacity for delivery remains challenged. Digital programs focusing on the psychosocial aspects of pain may provide low-barrier alternatives.
Aims: Through a randomized controlled trial, we investigated the effectiveness of a multimodal mobile application.
Methods: Participants (n = 198; 82% women, mean age = 46.7 [13.1] years; mean pain duration 13.6 [11.2] years) with nonmalignant chronic pain were randomized to either a 6-week intervention (n = 98) or a wait-listed usual care group (n = 100). The intervention involved regular engagement with a user-guided mobile application (Curable Inc.) informed by the biopsychosocial model of pain that included pain education, meditation, cognitive behavioral therapy, and expressive writing. The co-primary outcomes were pain severity and interference at 6 weeks.
Results: We observed significant improvements in the intervention group compared to the control group with estimated changes of -0.67 (95% confidence interval [CI] -1.04 to -0.29, P < .001, d = 0.43) and -0.60 (95% CI -1.18 to -0.03, P = .04, d = 0.27) for pain severity and interference, respectively. There were significant improvements across secondary outcomes (Patient-Reported Outcome Measurement Information System pain interference; pain catastrophizing; anxiety, depression; stress). Frequency of app use was correlated with improved pain interference (P < .001) and pain catastrophizing (P = 0.018), and changes from baseline persisted in the intervention group at 12 weeks (P < .05).
Conclusions: A short-term mobile app intervention resulted in significant improvements across physical and mental health outcomes compared to wait-listed usual care.