Trial Outcomes & Findings for Internet-based Behavioral Pain Management (NCT NCT01918189)

NCT ID: NCT01918189

Last Updated: 2019-11-18

Results Overview

Self-report measure of pain-related functional interference. The 9-item Interference subscale, scores ranging from 0-6, of the West Haven-Yale Multidimensional Pain Inventory (WHYMPI)-Interference scale assesses pain-related interference. Lower scores indicate less pain-related interference (i.e., better outcome). A reduction in WHYMPI-Interference Scale scores of 0.6 or greater has been identified as an indicator of meaningful improvement in physical functioning. Outcome was calculated as a change from baseline score to 10-week post-baseline score (i.e., 10 weeks post-baseline value minus baseline value).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

59 participants

Primary outcome timeframe

baseline and 10 weeks post-baseline

Results posted on

2019-11-18

Participant Flow

Participant enrollment began July 1, 2014 and last data collection for primary outcome was October 31, 2018. Recruitment target of 58 participants was met. 59 participants enrolled in the study (i.e., signed informed consent) but 58 completed baseline measures and were included in outcomes analyses.

Participant milestones

Participant milestones
Measure
10 Week Pain EASE Access
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Overall Study
STARTED
59
Overall Study
Completed Baseline Assessment
58
Overall Study
Completed Follow-up Assessment
41
Overall Study
COMPLETED
41
Overall Study
NOT COMPLETED
18

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Internet-based Behavioral Pain Management

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
10 Week Pain EASE Access
n=58 Participants
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
46 Participants
n=5 Participants
Age, Categorical
>=65 years
12 Participants
n=5 Participants
Age, Continuous
55 years
STANDARD_DEVIATION 12 • n=5 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
Sex: Female, Male
Male
54 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
54 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
3 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
19 Participants
n=5 Participants
Race (NIH/OMB)
White
35 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=5 Participants
Region of Enrollment
United States
58 Participants
n=5 Participants
Multidimensional Pain Inventory Interference Subscale
3.82 units on a scale
STANDARD_DEVIATION 0.19 • n=5 Participants
Pain Intensity Numeric Rating Scale
5.91 units on a scale
STANDARD_DEVIATION 0.25 • n=5 Participants
Profile of Mood States
49.53 units on a scale
STANDARD_DEVIATION 5.62 • n=5 Participants
Multidimensional Fatigue Inventory
14.05 units on a scale
STANDARD_DEVIATION 0.52 • n=5 Participants
Medical Outcomes Study Sleep Scale
50.09 units on a scale
STANDARD_DEVIATION 3.80 • n=5 Participants
Beck Depression Inventory
15.47 units on a scale
STANDARD_DEVIATION 1.37 • n=5 Participants

PRIMARY outcome

Timeframe: baseline and 10 weeks post-baseline

Population: 17 of the 58 participants who completed baseline did not complete 10-week post-baseline assessment (study endpoint)

Self-report measure of pain-related functional interference. The 9-item Interference subscale, scores ranging from 0-6, of the West Haven-Yale Multidimensional Pain Inventory (WHYMPI)-Interference scale assesses pain-related interference. Lower scores indicate less pain-related interference (i.e., better outcome). A reduction in WHYMPI-Interference Scale scores of 0.6 or greater has been identified as an indicator of meaningful improvement in physical functioning. Outcome was calculated as a change from baseline score to 10-week post-baseline score (i.e., 10 weeks post-baseline value minus baseline value).

Outcome measures

Outcome measures
Measure
10 Week Pain EASE Access
n=41 Participants
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Multidimensional Pain Inventory Interference Subscale
0.53 score on a scale
Interval 0.15 to 0.92

SECONDARY outcome

Timeframe: baseline and 10 weeks post-baseline

self-report measure of pain intensity measured on a 0-10 likert scale. Participants are asked, "Please rate your pain by indicating the number that best describes your average pain over the past week on a 0 (no pain) to 10 (pain as bad as you can imagine) scale". Scores of 1-3 reflect mild pain, 4-6 moderate pain, and 7-10 severe pain. Lower scores reflect less pain, and therefore, better outcome. Outcome was calculated as a change from baseline score to 10-week post-baseline score (i.e., 10 weeks post-baseline value minus baseline value).

Outcome measures

Outcome measures
Measure
10 Week Pain EASE Access
n=41 Participants
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Numeric Rating Scale of Pain Intensity
-0.24 units on a scale
Interval -0.29 to 0.2

SECONDARY outcome

Timeframe: baseline and 10 weeks post-baseline

Total mood symptoms score reported. The 65-item Profile of Mood States (POMS) is a multidimensional measure of emotional functioning designed to assess six dimensions of mood "over the past week, including today". Each item is scored on a 0-5 Likert scale, where 0= "not at all" and 5= "extremely". Total Mood Disturbance score ranges from 0 to 200. Higher scores reflect poorer functioning. Lower scores correspond to better outcomes. Outcome was calculated as a change from baseline score to 10-week post-baseline score (i.e., 10 weeks post-baseline value minus baseline value).

Outcome measures

Outcome measures
Measure
10 Week Pain EASE Access
n=41 Participants
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Profile of Mood States
-9.57 score on a scale
Interval -17.72 to -1.42

SECONDARY outcome

Timeframe: baseline and 10 weeks post-baseline

General fatigue scale reported. Fatigue was assessed using the Multidimensional Fatigue Inventory (MFI), which is a 20 item measure that can be scored to produce 5 dimensions: general fatigue, physical fatigue, mental fatigue, reduced motivation, and how subscale statements regarding fatigue represent their experiences. Score range from 4 to 20. Higher total scores correspond with more acute levels of fatigue. Lower scores correspond to better outcomes. Outcome was calculated as a change from baseline score to 10-week post-baseline score (i.e., 10 weeks post-baseline value minus baseline value).

Outcome measures

Outcome measures
Measure
10 Week Pain EASE Access
n=41 Participants
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Multidimensional Fatigue Inventory
-0.3 score on a scale
Interval -1.17 to 0.56

SECONDARY outcome

Timeframe: baseline and 10 weeks post-baseline

The MOS Sleep Scale is a 12 item measure that is segregated into subscales addressing seven sleep domains (i.e. sleep disturbance, snoring, awaken short of breath or with headache, adequacy of sleep, somnolence, a problems index 1 and a problems index 2). An additional single item assesses quantity of sleep. The sleep domains and problems index are scored on a 0 - 100 possible range, and higher scores indicate more of the concept being measured. Lower scores on sleep disturbance, for example, reflect less disturbed sleep, which is a better outcome. Outcome was calculated as a change from baseline score to 10-week post-baseline score (i.e., 10 weeks post-baseline value minus baseline value).

Outcome measures

Outcome measures
Measure
10 Week Pain EASE Access
n=41 Participants
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Medical Outcomes Study Sleep Scale
-4.95 score on a scale
Interval -12.27 to 2.38

SECONDARY outcome

Timeframe: baseline and 10 weeks post-baseline

Depressive symptom severity was assessed using the 21-item Beck Depression Inventory. Scores range from 0 - 63. Higher scores indicate more severe depression symptomatology. Lower scores correspond to better outcomes (i.e., less depressive symptom severity). Outcome was calculated as a change from baseline score to 10-week post-baseline score (i.e., 10 weeks post-baseline value minus baseline value).

Outcome measures

Outcome measures
Measure
10 Week Pain EASE Access
n=41 Participants
behavioral pain self-management intervention (Pain EASE) delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing
Beck Depression Inventory
-2.31 score on a scale
Interval -4.37 to -0.25

Adverse Events

10 Week Pain EASE Access

Serious events: 1 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
10 Week Pain EASE Access
n=58 participants at risk
behavioral pain self-management intervention (Pain EASE) for chronic low back pain delivered via the Internet behavioral pain self-management intervention Pain EASE: 10 modules describing behavioral and cognitive pain coping skills such as relaxation and stress reduction methods, exercise and structured physical activity, and activity pacing Access to the Pain EASE intervention for 10 weeks: analyses were conducted to determine change from baseline on pain-related functional interference and other outcomes
Psychiatric disorders
psychiatric emergency room visit
1.7%
1/58 • Number of events 1 • 10 weeks of active study participation

Other adverse events

Adverse event data not reported

Additional Information

Diana M. Higgins, PhD

VA Boston Healthcare System

Phone: 857-364-2221

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place