A guided and unguided internet- and mobile-based intervention for chronic pain: health economic evaluation alongside a randomised controlled trial

Paganini, Sarah; Lin, Jiaxi; Kählke, Fanny; Buntrock, Claudia; Leiding, Delia; Ebert, David Daniel; Baumeister, Harald

doi:10.1136/bmjopen-2018-023390

Cited by 21 publications

(26 citation statements)

References 68 publications

(68 reference statements)

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“…A recent randomized controlled trial (RCT) on an IMI based on Acceptance and Commitment Therapy (ACT) showed guided, but not unguided, IMIs being effective in improving pain interference (Cohen d =0.58 at posttreatment and follow-up, respectively [ 22 ]) in individuals with chronic, nonmalignant pain for 6 months or longer. Moreover, changes in psychological flexibility mediated all outcomes of ACT-based online treatment for chronic pain (ACTonPain) [ 23 ], and cost-effectiveness analyses revealed that ACTonPain is potentially cost-effective, depending on the amount of society’s willingness to pay [ 24 ]. In this trial, the uptake rate was 97% in both ACTonPain groups, and guided participants completed more modules (0-8) than those who were unguided (mean 5.94, SD 2.80 vs mean 4.74, SD 2.89, F 1,199 =8.92; P <.01).…”

Section: Introductionmentioning

confidence: 99%

A Web-Based Acceptance-Facilitating Intervention for Identifying Patients' Acceptance, Uptake, and Adherence of Internet- and Mobile-Based Pain Interventions: Randomized Controlled Trial

Lin¹,

Faust²,

Ebert³

et al. 2018

J Med Internet Res

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BackgroundInternet- and mobile-based interventions are effective for the treatment of chronic pain. However, little is known about patients’ willingness to engage with these types of interventions and how the uptake of such interventions can be improved.ObjectiveThe aim of this study was to identify people’s acceptance, uptake, and adherence (primary outcomes) with regard to an internet- and mobile-based intervention for chronic pain and the influence of an information video as an acceptance-facilitating intervention (AFI).MethodsIn this randomized controlled trial with a parallel design, we invited 489 individuals with chronic pain to participate in a Web-based survey assessing the acceptance of internet- and mobile-based interventions with the offer to receive an unguided internet- and mobile-based intervention for chronic pain after completion. Two versions of the Web-based survey (with and without AFI) were randomly sent to two groups: one with AFI (n=245) and one without AFI (n=244). Participants who completed the Web-based survey with or without AFI entered the intervention group or the control group, respectively. In the survey, the individuals’ acceptance of pain interventions, measured with a 4-item scale (sum score ranging from 4 to 20), predictors of acceptance, sociodemographic and pain-related variables, and physical and emotional functioning were assessed. Uptake rates (log in to the intervention) and adherence (number of completed modules) to the intervention was assessed 4 months after intervention access. To examine which factors influence acceptance, uptake rate, and adherence in the internet- and mobile-based interventions, we conducted additional exploratory subgroup analyses.ResultsIn total, 57 (intervention group) and 58 (control group) participants in each group completed the survey and were included in the analyses. The groups did not differ with regard to acceptance, uptake rate, or adherence (P=.64, P=.56, P=.75, respectively). Most participants reported moderate (68/115, 59.1%) to high (36/115, 31.3%) acceptance, with 9.6% (11/115) showing low acceptance (intervention group: mean 13.91, SD 3.47; control group: mean 13.61, SD 3.50). Further, 67% (38/57, intervention group) and 62% (36/58, control group) had logged into the intervention. In both groups, an average of 1.04 (SD 1.51) and 1.14 (SD 1.90) modules were completed, respectively.ConclusionsThe informational video was not effective with regard to acceptance, uptake rate, or adherence. Despite the high acceptance, the uptake rate was only moderate and adherence was remarkably low. This study shows that acceptance can be much higher in a sample participating in an internet- and mobile-based intervention efficacy trial than in the target population in routine health care settings. Thus, future research should focus not only on acceptance and uptake facilitating interventions but also on ways to influence adherence. Further research should be conducted within routine health care settings with more representative samples of the target p...

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Section: Introductionmentioning

confidence: 99%

A Web-Based Acceptance-Facilitating Intervention for Identifying Patients' Acceptance, Uptake, and Adherence of Internet- and Mobile-Based Pain Interventions: Randomized Controlled Trial

Lin¹,

Faust²,

Ebert³

et al. 2018

J Med Internet Res

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“…Contents were adapted to the population of people with diabetes from the already evaluated ACTonPain intervention. [49][50][51] The intervention consists of seven modules.…”

Section: Actondiabetes Interventionmentioning

confidence: 99%

“…48 To our knowledge, this is the first study on an ACTbased internet intervention aiming at reducing elevated diabetes distress. Notably, the effectiveness and costeffectiveness of the internet intervention 'ACTonPain' aiming at reducing pain-related burden in people with chronic pain were supported in studies by Lin et al [49][50][51] ACTonDiabetes was built on the ACTonPain treatment programme to develop a widely practicable, local and temporal flexible, low-threshold internet intervention to reduce diabetes distress in people with type 1 and type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

ACTonDiabetes—a guided psychological internet intervention based on Acceptance and Commitment Therapy (ACT) for adults living with type 1 or 2 diabetes: results of a randomised controlled feasibility trial

et al. 2021

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ObjectivesThis two-group randomised controlled trial evaluates the feasibility of an Acceptance and Commitment Therapy (ACT)-based internet intervention for diabetes distress in people with diabetes type 1 or type 2. Participants were assigned to a guided self-help intervention (EG) or waitlist control group (CG).SettingRecruitment took place following an open recruitment strategy including different diabetes centres, self-help groups and social media platforms.ParticipantsEligibility criteria comprised being 18 years of age or older, self-reported diagnosis of type 1 or type 2 diabetes, internet access, sufficient German language skills and written informed consent.InterventionACTonDiabetes is an internet-based and mobile-based intervention and comprises an introduction and seven modules (one module per week, processing time about 45–60 min). Intervention contents are based on ACT.Primary and secondary outcome measuresParticipants were assessed before and 8 weeks after randomisation. Primary outcome was feasibility (trial recruitment, acceptability). Potential group differences in diabetes distress and other outcomes at follow-up were analysed using linear regression models with baseline values as predictors. All analyses were based on an intention-to-treat principle, potential negative effects were analysed on per-protocol basis.ResultsFrom October 2017 to April 2018, N=42 people with diabetes consented and were randomised (EG n=21, CG n=21). Forty-three per cent of the EG completed all treatment modules within 8 weeks. Across modules, formative user feedback revealed that contents could be optimised regarding comprehensibility (34%), individualisation (20%) and text amount (21%). Overall, 57% of participants dropped out prior to full treatment completion. There were reductions of diabetes distress in the EG (d=0.65, p=0.042).ConclusionsModifications of the intervention content according to the user feedback will be performed to further improve acceptability. Mechanisms to foster intervention adherence should be considered for lowering the attrition rate. ACTonDiabetes is feasible for the implementation in a confirmatory trial.Trial registration numberWHO International Clinical Trials Registry Platform via the German Clinical Trials Register (DRKS) (DRKS00013193).

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“…We identified no other reviews on group PMPs that include synchronous VC. Literature related to online or web-based PMPs that explore self-directed online resources, sometimes coupled with individual appointments or text contact with healthcare professionals has been published [22][23][24].…”

Section: Comparison With Other Reviewsmentioning

confidence: 99%

Pain management programmes via video conferencing: a rapid review

Walumbe

Belton²,

Denneny

2020

Scandinavian Journal of Pain

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ObjectivesDuring the current COVID-19 pandemic, healthcare has been transformed by the rapid switch from in person care to use of remote consulting, including video conferencing technology. Whilst much has been published on one-to-one video consultations, little literature exists on use of this technology to facilitate group interventions. Group pain management programmes are a core treatment provided by many pain services. This rapid review aimed to identify the extent of use of video conferencing technology for delivery of group pain management programmes and provide an overview of its use.MethodsA rapid review of the literature published up to April 2020 (PubMed, PsycINFO and PEDro) was performed. The search string consisted of three domains: pain/CP (MeSH term) AND Peer group[MeSH] AND Videoconferencing[MeSH]/Telemedicine[MeSH]/Remote Consultation[MeSH]. The studies were of poor methodological quality and study design, and interventions and chronic pain conditions were varied.ResultsLiterature searching yielded three eligible papers for this review. All studies had low methodological quality and risk of bias. Heterogeneity and variability in outcome reporting did not allow any pooling of data. The results demonstrated that videoconferencing for delivery of group programmes is possible, yet there is little extant literature on how to develop, deliver and measure outcomes of such programmes.ConclusionsThis review demonstrates that there is little evidence to support or guide the use of synchronous videoconferencing to deliver pain management programmes. We present issues to consider, informed by this review and our experience, when implementing video conferencing. Study quality of existing work is variable, and extensive future research is necessary.

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A guided and unguided internet- and mobile-based intervention for chronic pain: health economic evaluation alongside a randomised controlled trial

Cited by 21 publications

References 68 publications

A Web-Based Acceptance-Facilitating Intervention for Identifying Patients' Acceptance, Uptake, and Adherence of Internet- and Mobile-Based Pain Interventions: Randomized Controlled Trial

A Web-Based Acceptance-Facilitating Intervention for Identifying Patients' Acceptance, Uptake, and Adherence of Internet- and Mobile-Based Pain Interventions: Randomized Controlled Trial

ACTonDiabetes—a guided psychological internet intervention based on Acceptance and Commitment Therapy (ACT) for adults living with type 1 or 2 diabetes: results of a randomised controlled feasibility trial

Pain management programmes via video conferencing: a rapid review

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