Enhancing Exposure Treatment for Youths With Chronic Pain: Co-design and Qualitative Approach

Schemer, Lea; Hess, Courtney W.; Orden, Amanda R Van; Birnie, Kathryn A.; Harrison, Lauren E.; Glombiewski, Julia; Simons, Laura E.

doi:10.2196/41292

Cited by 4 publications

(1 citation statement)

References 41 publications

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“…After compiling exit interview data from the single arm pilot and current trial GL participants, we held codesign meetings with patient and parent research partners. 48 The research partners devised several ideas for improving exposure treatment in youth with major recommendations focused on education to primary care providers to facilitate earlier treatment referral, flexibility in delivery (duration, frequency, and delivery method), and incorporating patient voice when educating others about exposure treatment for youth with chronic pain by testimonials.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

Simons,

Harrison,

Boothroyd

et al. 2023

PAIN

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Graded exposure treatment (GET) is a theory-driven pain treatment that aims to improve functioning by exposing patients to activities previously feared and avoided. Combining key elements of GET with acceptance-based exposure, GET Living (GL) was developed for adolescents with chronic pain (GL). Based on robust treatment effects observed in our single-case experimental design pilot trial of GL (NCT01974791), we conducted a 2-arm randomized clinical trial comparing GL with multidisciplinary pain management (MPM) comprised of cognitive behavioral therapy and physical therapy for pain management (NCT03699007). A cohort of 68 youth with chronic musculoskeletal pain (M age 14.2 years; 81% female) were randomized to GL or MPM. Owing to COVID-19 restrictions, 54% of participants received zoom video delivered care. Assessments were collected at baseline, discharge, as well as at 3-month and 6-month follow-up. Primary outcomes were self-reported pain-related fear and avoidance. Secondary outcomes were child functional disability and parent protective responses to child pain. As hypothesized, GL improved in primary and secondary outcomes at 3-month follow-up. Contrary to our superiority hypothesis, there was no significant difference between GL and MPM. Patients reported both GL and MPM (in person and video) as credible and were highly satisfied with the treatment experience. Next steps will involve examining the single-case experimental design data embedded in this trial to facilitate an understanding of individual differences in treatment responses (eg, when effects occurred, what processes changed during treatment within the treatment arm). The current findings support GET Living and MPM for youth with chronic pain.

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Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

Simons,

Harrison,

Boothroyd

et al. 2023

PAIN

View full text Add to dashboard Cite

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Meaningful Clinical Outcomes for Young People and Parents When Treated for Chronic Musculoskeletal Pain in the UK: Q Set Development

Joslin,

Donovan-Hall,

Roberts

2024

The Journal of Pain

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Digital Health Secondary Prevention Using Co-Design Procedures: Focus Group Study With Health Care Providers and Patients With Myocardial Infarction

Pelly,

Fatehi,

Liew

et al. 2023

JMIR Cardio

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Background Myocardial infarction (MI) is a debilitating condition and a leading cause of morbidity and mortality worldwide. Digital health is a promising approach for delivering secondary prevention to support patients with a history of MI and for reducing risk factors that can lead to a future event. However, its potential can only be fulfilled when the technology meets the needs of the end users who will be interacting with this secondary prevention. Objective We aimed to gauge the opinions of patients with a history of MI and health professionals concerning the functions, features, and characteristics of a digital health solution to support post-MI care. Methods Our approach aligned with the gold standard participatory co-design procedures enabling progressive refinement of feedback via exploratory, confirmatory, and prototype-assisted feedback from participants. Patients with a history of MI and health professionals from Australia attended focus groups over a videoconference system. We engaged with 38 participants across 3 rounds of focus groups using an iterative co-design approach. Round 1 included 8 participants (4 patients and 4 health professionals), round 2 included 24 participants (11 patients and 13 health professionals), and round 3 included 22 participants (14 patients and 8 health professionals). Results Participants highlighted the potential of digital health in addressing the unmet needs of post-MI care. Both patients with a history of MI and health professionals agreed that mental health is a key concern in post-MI care that requires further support. Participants agreed that family members can be used to support postdischarge care and require support from the health care team. Participants agreed that incorporating simple games with a points system can increase long-term engagement. However, patients with a history of MI emphasized a lack of support from their health care team, family, and community more strongly than health professionals. They also expressed some openness to using artificial intelligence, whereas health professionals expressed that users should not be aware of artificial intelligence use. Conclusions These results provide valuable insights into the development of digital health secondary preventions aimed at supporting patients with a history of MI. Future research can implement a pilot study in the population with MI to trial these recommendations in a real-world setting.

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Enhancing Exposure Treatment for Youths With Chronic Pain: Co-design and Qualitative Approach

Cited by 4 publications

References 41 publications

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

Meaningful Clinical Outcomes for Young People and Parents When Treated for Chronic Musculoskeletal Pain in the UK: Q Set Development

Digital Health Secondary Prevention Using Co-Design Procedures: Focus Group Study With Health Care Providers and Patients With Myocardial Infarction

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