A randomized controlled trial of an online self-management program for adults with arthritis pain

Trudeau, Kimberlee J.; Pujol, L.; DasMahapatra, Pronabesh; Wall, R. de; Black, Ryan A.; Zacharoff, K.

doi:10.1007/s10865-015-9622-9

Cited by 48 publications

(59 citation statements)

References 61 publications

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“…Interestingly, the trial with the lowest risk of bias incorporated the greatest number of BCTs and several methods of communication in the intervention [33] and this was the only trial which reported any benefit of IDIs on PA. Additionally, this trial found that those participants who had high levels of engagement with the intervention (75–100% website usage rate) had greater improvements [33]. This corresponds with findings from an earlier study where higher internet user engagement was significantly associated with improved self-management outcomes, including self-efficacy and reduced catastrophizing, in an arthritic population [61]. There is limited evidence to guide selection, number and dosage of BCTs to be included in interventions promoting adherence to health related behaviour change [62, 63].…”

Section: Discussionsupporting

confidence: 76%

The effect of interactive digital interventions on physical activity in people with inflammatory arthritis: a systematic review

et al. 2018

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The aim of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) evaluating the effectiveness of interactive digital interventions (IDIs) for physical activity (PA) and health related quality of life (HRQoL) in people with Inflammatory Arthritis [rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) axial Spondyloarthritis (AS) and psoriatic arthritis (PsA)]. Seven electronic databases identified published and unpublished studies. Two reviewers conducted independent data extraction and quality assessment using the Cochrane risk of bias tool (RoB). The primary outcome was change in objective PA after the intervention; secondary outcomes included self-reported PA and HRQoL after the intervention and objective or self-reported PA at least 1 year later. Five manuscripts, reporting four RCTs (three high and one low RoB) representing 492 (459 RA, 33 JIA) participants were included. No trials studying PsA or AS met the inclusion criteria. Interventions ranged from 6 to 52 weeks and included 3–18 Behaviour Change Techniques. Due to heterogeneity of outcomes, a narrative synthesis was conducted. No trials reported any significant between group differences in objective PA at end of intervention. Only one low RoB trial found a significant between group difference in self-reported vigorous [MD Δ 0.9 days (95% CI 0.3, 1.5); p = 0.004], but not moderate, PA in people with RA but not JIA. There were no between group differences in any other secondary outcomes. There is very limited evidence for the effectiveness of IDIs on PA and HRQoL in RA and JIA and no evidence for their effectiveness in PsA or AS.Electronic supplementary materialThe online version of this article (10.1007/s00296-018-4010-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 76%

The effect of interactive digital interventions on physical activity in people with inflammatory arthritis: a systematic review

et al. 2018

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“…Improving coping skills or decreasing "pain catastrophizing" have been noted as a benefit of several other online programs targeting self-management [24,25,26]. Throughout the data, participants described now having the tools to take a step back and reframe their negative thought patterns that were often associated with pain.…”

Section: Discussionmentioning

confidence: 92%

“…People with chronic pain desire online programs that include information, activities and tools that will help them feel equipped to gain back control [26,31]. Our study participants often described that they appreciated receiving positive affirmations and reminders as part of the program and that this allowed them to check in with their progress.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies have identified benefits of online self-management programs as improved accountability or improved awareness of ones' ability to choose positive actions and behaviors in living with and managing chronic pain [24,25,26]. People with chronic pain desire online programs that include information, activities and tools that will help them feel equipped to gain back control [26,31].…”

Section: Discussionmentioning

confidence: 99%

“…Including subjective, individualized components to online programs is a common thread noted throughout the literature to meet participants' needs [24,25,26,31]. While the CPMP does offer daily tracking and activity scheduling that can be personalized, these features were also ones that seemed to cause the most technical difficulties for some participants.…”

Section: Discussionmentioning

confidence: 99%

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“Focus on the Good” - Participant Perspectives after Engaging in an Online Pain Self-Management Program

Wilson¹,

Shaw

2017

Proceedings of the 50th Hawaii International Conference on System Sciences (2017)

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The purpose of this study was to evaluate participants' perspectives after engaging in an 8-week online pain self-management program. Unexplored qualitative data for this analysis were collected via secure online surveys distributed during a previously published randomized controlled trial. Participants for the present study were 55 adults prescribed opioid medicines for chronic pain. A qualitative descriptive approach using content analysis methods was used to analyze data obtained from three open-ended survey questions. Five common themes were identified from participant responses regarding online participation. Three themes described the benefits of the program and included: positive reframing, improved accountability, and feeling supported. Two themes described how participants would like to improve the program experience and included: desire for personalizing and ease of use. Participants' insights regarding perceived benefits and limitations can assist health care providers in understanding how online programs may assist in chronic disease selfmanagement for a multitude of health problems.

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Internet-delivered cognitive behaviour therapy for chronic health conditions: a systematic review and meta-analysis

2018

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This systematic review and meta-analysis aims to evaluate the effectiveness of internet-delivered cognitive behavioural therapy (ICBT) on anxiety and depression among persons with chronic health conditions. A systematic database search was conducted of MEDLINE, CINAHL, PsycInfo, EMBASE, and Cochrane for relevant studies published from 1990 to September 2018. A study was included if the following criteria were met: (1) randomized controlled trial involving an ICBT intervention; (2) participants experienced a chronic health condition; (3) participants C 18 years of age; and (4) effects of ICBT on anxiety and/or depression were reported. The Cochrane Risk of Bias tool was used to assess the risk of bias on the included studies. Pooled analysis was conducted on the primary and condition specific secondary outcomes. Twenty-five studies met inclusion criteria and investigated the following chronic health conditions: tinnitus (n = 6), fibromyalgia (n = 3), pain (n = 7), rheumatoid arthritis (n = 3), cardiovascular disease (n = 2), diabetes (n = 1), cancer (n = 1), heterogeneous chronic disease population (n = 1), and spinal cord injury (n = 1). Pooled analysis demonstrated small effects of ICBT in improving anxiety and depression. Moderate effects of therapist-guided approach were seen for depression and anxiety outcomes; while, self-guided approaches resulted in small effects for depression and moderate effects in anxiety outcomes. ICBT shows promise as an alternative to traditional faceto-face interventions among persons with chronic health conditions. Future research on long-term effects of ICBT for individuals with chronic health conditions is needed.Trial Registration PROSPERO registration number: CRD42018087292.

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A randomized controlled trial of an online self-management program for adults with arthritis pain

Cited by 48 publications

References 61 publications

The effect of interactive digital interventions on physical activity in people with inflammatory arthritis: a systematic review

The effect of interactive digital interventions on physical activity in people with inflammatory arthritis: a systematic review

“Focus on the Good” - Participant Perspectives after Engaging in an Online Pain Self-Management Program

Internet-delivered cognitive behaviour therapy for chronic health conditions: a systematic review and meta-analysis

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