David Kiefer, Yade Sonkaya, Dietmar Krause, Markus Voglau, Bernhard Mintrop, Imke Redeker, Xenofon Baraliakos, Uta Kiltz
{"title":"数字行为疗法改善轴型脊柱炎和持续性疼痛患者的预后：一项随机对照试验。","authors":"David Kiefer, Yade Sonkaya, Dietmar Krause, Markus Voglau, Bernhard Mintrop, Imke Redeker, Xenofon Baraliakos, Uta Kiltz","doi":"10.1002/acr.25679","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Axial spondyloarthritis (axSpA) is often associated with persistent pain despite effective anti-inflammatory treatment. Digital health applications (DHA) provide innovative approaches to address multidimensional aspects of persistent pain through psychological and behavioral strategies. The aim of this study was to assess the impact of a DHA utilizing the acceptance and commitment therapy (ACT) on disease outcomes, including the West-Haven-Yale-Multidimensional-Pain-Inventory (MPI), in axSpA patients experiencing persistent pain despite stable pharmacological therapy.</p><p><strong>Methods: </strong>This unblinded, multicentric, randomized controlled trial compared an intervention group (IG) receiving the ACT-app with a standard of care (SOC) group. The ACT-app provided behavioral therapy. The primary outcome was MPI pain-related-life-interference; secondary outcomes included pain severity, affective distress and other patient reported outcomes after 12 weeks. Linear models estimating the effect of the ACT-app on the change of MPI pain-related life interference and affective distress were calculated.</p><p><strong>Results: </strong>136 patients were randomized to IG (n=73) with ACT-app and SOC (n=63) without ACT-app. Among IG, 44 actively used ACT-app. All lessons in the ACT-app were completed by 19 (43%) IG patients. Baseline characteristics, including MPI-scores, were comparable between groups. IG showed a reduction in pain-related-life-interference as well as in other outcomes. The improvements in pain-related-life-interference (-0.36, 95%CI: -0.73 to 0.01) and affective distress related to the disease (-0.4, 95%CI: -0.84 to 0.03) were greater compared to SOC.</p><p><strong>Conclusion: </strong>The ACT-app demonstrated a meaningful reduction in pain-related-life-interference, supporting that DHAs might become a complementary tool in managing pain for axSpA patients. Studies about improvement of adherence to DHAs are warranted.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Digital behavioral therapy improves outcome in patients with axial spondyloarthritis and persistent pain: a randomized controlled trial.\",\"authors\":\"David Kiefer, Yade Sonkaya, Dietmar Krause, Markus Voglau, Bernhard Mintrop, Imke Redeker, Xenofon Baraliakos, Uta Kiltz\",\"doi\":\"10.1002/acr.25679\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Axial spondyloarthritis (axSpA) is often associated with persistent pain despite effective anti-inflammatory treatment. Digital health applications (DHA) provide innovative approaches to address multidimensional aspects of persistent pain through psychological and behavioral strategies. The aim of this study was to assess the impact of a DHA utilizing the acceptance and commitment therapy (ACT) on disease outcomes, including the West-Haven-Yale-Multidimensional-Pain-Inventory (MPI), in axSpA patients experiencing persistent pain despite stable pharmacological therapy.</p><p><strong>Methods: </strong>This unblinded, multicentric, randomized controlled trial compared an intervention group (IG) receiving the ACT-app with a standard of care (SOC) group. The ACT-app provided behavioral therapy. The primary outcome was MPI pain-related-life-interference; secondary outcomes included pain severity, affective distress and other patient reported outcomes after 12 weeks. Linear models estimating the effect of the ACT-app on the change of MPI pain-related life interference and affective distress were calculated.</p><p><strong>Results: </strong>136 patients were randomized to IG (n=73) with ACT-app and SOC (n=63) without ACT-app. Among IG, 44 actively used ACT-app. All lessons in the ACT-app were completed by 19 (43%) IG patients. Baseline characteristics, including MPI-scores, were comparable between groups. IG showed a reduction in pain-related-life-interference as well as in other outcomes. The improvements in pain-related-life-interference (-0.36, 95%CI: -0.73 to 0.01) and affective distress related to the disease (-0.4, 95%CI: -0.84 to 0.03) were greater compared to SOC.</p><p><strong>Conclusion: </strong>The ACT-app demonstrated a meaningful reduction in pain-related-life-interference, supporting that DHAs might become a complementary tool in managing pain for axSpA patients. Studies about improvement of adherence to DHAs are warranted.</p>\",\"PeriodicalId\":8406,\"journal\":{\"name\":\"Arthritis Care & Research\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthritis Care & Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/acr.25679\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthritis Care & Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/acr.25679","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Digital behavioral therapy improves outcome in patients with axial spondyloarthritis and persistent pain: a randomized controlled trial.
Objectives: Axial spondyloarthritis (axSpA) is often associated with persistent pain despite effective anti-inflammatory treatment. Digital health applications (DHA) provide innovative approaches to address multidimensional aspects of persistent pain through psychological and behavioral strategies. The aim of this study was to assess the impact of a DHA utilizing the acceptance and commitment therapy (ACT) on disease outcomes, including the West-Haven-Yale-Multidimensional-Pain-Inventory (MPI), in axSpA patients experiencing persistent pain despite stable pharmacological therapy.
Methods: This unblinded, multicentric, randomized controlled trial compared an intervention group (IG) receiving the ACT-app with a standard of care (SOC) group. The ACT-app provided behavioral therapy. The primary outcome was MPI pain-related-life-interference; secondary outcomes included pain severity, affective distress and other patient reported outcomes after 12 weeks. Linear models estimating the effect of the ACT-app on the change of MPI pain-related life interference and affective distress were calculated.
Results: 136 patients were randomized to IG (n=73) with ACT-app and SOC (n=63) without ACT-app. Among IG, 44 actively used ACT-app. All lessons in the ACT-app were completed by 19 (43%) IG patients. Baseline characteristics, including MPI-scores, were comparable between groups. IG showed a reduction in pain-related-life-interference as well as in other outcomes. The improvements in pain-related-life-interference (-0.36, 95%CI: -0.73 to 0.01) and affective distress related to the disease (-0.4, 95%CI: -0.84 to 0.03) were greater compared to SOC.
Conclusion: The ACT-app demonstrated a meaningful reduction in pain-related-life-interference, supporting that DHAs might become a complementary tool in managing pain for axSpA patients. Studies about improvement of adherence to DHAs are warranted.
期刊介绍：
Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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