Efficacy of Internet-delivered cognitive-behavioral therapy for the management of chronic pain in children and adolescents

Tang, Wenxin; Zhang, Lu-Feng; Ai, Yanqiu; Li, Zhisong

doi:10.1097/md.0000000000012061

Cited by 33 publications

(34 citation statements)

References 41 publications

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“…To the best of our knowledge, there are no systematic reviews that specifically investigate digital interventions for the management of chronic health conditions in children (aged <13 years). Furthermore, reviews investigating digital interventions for young people with chronic health conditions typically do not include children aged below 10 years [ 35 ], or, if they do, only a minority of the interventions included in the reviews include children aged below 13 years [ 15 , 36 - 38 ], recognizing that there are “fewer interventions targeting…the extreme pediatric age ranges of early childhood and emerging adulthood” [ 16 ]. The reviews spanning childhood and adolescence note important differences between these age groups.…”

Section: Introductionmentioning

confidence: 99%

Digital Behavior Change Interventions for Younger Children With Chronic Health Conditions: Systematic Review

Brigden¹,

Anderson²,

Linney³

et al. 2020

J Med Internet Res

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Background The prevalence of chronic health conditions in childhood is increasing, and behavioral interventions can support the management of these conditions. Compared with face-to-face treatment, the use of digital interventions may be more cost-effective, appealing, and accessible, but there has been inadequate attention to their use with younger populations (children aged 5-12 years). Objective This systematic review aims to (1) identify effective digital interventions, (2) report the characteristics of promising interventions, and (3) describe the user’s experience of the digital intervention. Methods A total of 4 databases were searched (Excerpta Medica Database [EMBASE], PsycINFO, Medical Literature Analysis and Retrieval System Online [MEDLINE], and the Cochrane Library) between January 2014 and January 2019. The inclusion criteria for studies were as follows: (1) children aged between 5 and 12 years, (2) interventions for behavior change, (3) randomized controlled trials, (4) digital interventions, and (5) chronic health conditions. Two researchers independently double reviewed papers to assess eligibility, extract data, and assess quality. Results Searches run in the databases identified 2643 papers. We identified 17 eligible interventions. The most promising interventions (having a beneficial effect and low risk of bias) were 3 targeting overweight or obesity, using exergaming or social media, and 2 for anxiety, using web-based cognitive behavioral therapy (CBT). Characteristics of promising interventions included gaming features, therapist support, and parental involvement. Most were purely behavioral interventions (rather than CBT or third wave), typically using the behavior change techniques (BCTs) feedback and monitoring, shaping knowledge, repetition and substitution, and reward. Three papers included qualitative data on the user’s experience. We developed the following themes: parental involvement, connection with a health professional is important for engagement, technological affordances and barriers, and child-centered design. Conclusions Of the 17 eligible interventions, digital interventions for anxiety and overweight or obesity had the greatest promise. Using qualitative methods during digital intervention development and evaluation may lead to more meaningful, usable, feasible, and engaging interventions, especially for this underresearched younger population. The following characteristics could be considered when developing digital interventions for younger children: involvement of parents, gaming features, additional therapist support, behavioral (rather than cognitive) approaches, and particular BCTs (feedback and monitoring, shaping knowledge, repetition and substitution, and reward). This review suggests a model for improving the conceptualization and reporting of behavioral interventions involving children and parents.

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Section: Introductionmentioning

confidence: 99%

Digital Behavior Change Interventions for Younger Children With Chronic Health Conditions: Systematic Review

Brigden¹,

Anderson²,

Linney³

et al. 2020

J Med Internet Res

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“…Systematic reviews and meta-analyses have shown promising outcomes for e-therapies in a range of populations (e.g. Barak et al, 2008 ; Tang et al, 2018 ). The NHS Long Term Plan, published before the COVID-19 outbreak, detailed hopes for increasing the availability of digital health care ( NHS, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Business as usual? Psychological support at a distance

Payne

Flannery

Gedara

et al. 2020

Clin Child Psychol Psychiatry

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The impact of COVID-19 has challenged the long accepted ‘norm’ in delivery of psychological therapy. Public policies designed to reduce transmission have made it extremely difficult to meet with service-users safely in the traditional face-to-face context. E-therapies have existed in theory and practice since technological progress has made them possible. They can offer a host of advantages over face-to-face equivalents, including improved access, greater flexibility for service-users and professionals, and cost savings. However, despite the emerging evidence and anticipated positive value, implementation has been slower than anticipated. Concerns have been raised by service-users, clinicians, and public health organisations, identifying significant barriers to the wide spread use of e-therapies. In the current climate, many clinicians are offering e-therapies for the first time, without prior arrangement or training, as the only viable option to continue to support their clients. This paper offers a clinically relevant review of the e-therapies literature, including effectiveness and acceptability dilemmas and challenges that need to be addressed to support the safe use and growth of e-therapies in psychology services. Further research is needed to better understand what might be lost and what gained in comparison to face-to-face therapy, and for which client groups and settings it might be most effective.

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“…Web-based intervention is expected to be an effective way to cope with chronic neck pain and related issues 13,14) . Web-based interventions have the following benefits compared to conventional methods.…”

Section: Ofmentioning

confidence: 99%

Factors for reducing monetary loss due to presenteeism using a tailored healthcare web-application among office workers with chronic neck pain: a single-arm pre-post comparison study

Odake

Fukutani

Shimoura

et al. 2021

EOH-P

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Objectives: This study aimed to examine the factors for reducing monetary loss due to presenteeism by using a tailored healthcare web-application among office workers with chronic neck pain. Methods: The study was singlearm pre-post comparison study using secondary data of 130 Japanese office workers with chronic neck pain who used a tailored healthcare web-application (web-app) over 12 weeks. This data was obtained from BackTech Inc. (Kyoto, Japan), which manages the healthcare web-app. The primary outcome measure was the monetary loss due to presenteeism based on the quality and quantity method. Secondary outcome measures were intensity of physical symptoms measured by the Visual Analog Scale, frequency of web-app use obtained from the database, and the risk of depression score assessed by the Depression and Suicide Screen. Results: Eighty-six participants were included in the complete-case analysis. Monetary loss due to presenteeism and the risk of depression reduced, while physical symptoms improved significantly ( p< 0.01) after using the web-app. After covariate adjustment, decrease in neck pain intensity (β = 0.25, confidence interval = 2.34 to 32.66) and high frequency of web-app use (β = −0.24, confidence interval = −10.29 to − 0.63) were significantly associated with a reduction in monetary loss due to presenteeism. Conclusion: Neck pain intensity and frequency of web-app use may be important factors for reducing monetary loss due to presenteeism among office workers with chronic neck pain who used a tailored health care web-app.

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Efficacy of Internet-delivered cognitive-behavioral therapy for the management of chronic pain in children and adolescents

Cited by 33 publications

References 41 publications

Digital Behavior Change Interventions for Younger Children With Chronic Health Conditions: Systematic Review

Digital Behavior Change Interventions for Younger Children With Chronic Health Conditions: Systematic Review

Business as usual? Psychological support at a distance

Factors for reducing monetary loss due to presenteeism using a tailored healthcare web-application among office workers with chronic neck pain: a single-arm pre-post comparison study

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