Feasibility and pilot testing of a personalized eHealth intervention for pain science education and self-management for breast cancer survivors with persistent pain: a mixed-method study

Groef, An De; Evenepoel, Margaux; Dijck, Sophie Van; Dams, Lore; Haenen, Vincent; Wiles, Louise; Catley, Mark J.; Vogelzang, Anna; Olver, Ian; Hibbert, Peter; Morlion, Bart; Moseley, G. Lorimer; Heathcote, Lauren C.; Meeus, Mira

doi:10.1007/s00520-022-07557-7

Cited by 14 publications

(25 citation statements)

References 58 publications

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“…After completing that assessment, articles were analyzed to determine their suitability. Only 12 articles [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ] met the established inclusion criteria ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of Therapeutic Education in Patients with Cancer Pain: Systematic Review and Meta-Analysis

González-Martín,

Aguilera-García,

Castellote-Caballero

et al. 2023

Cancers

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(1) Objective: To review the existing evidence on pain education in patients with pain derived from an oncological process. (2) Methods: A systematic review was conducted using the databases Pubmed, Web of Science, PEDro, and Scopus. The selected studies had to incorporate instruction about the neurophysiology of pain into their educational program. The target population was cancer patients who had suffered pain for at least one month. The methodological quality of the articles collected was assessed using the PEDro scale. (3) Results: Some 698 studies were initially identified, of which 12 were included in this review. Four different models of pain education programs were found in the studies’ interventions. Pain intensity, pain experience, quality of life, pain tolerance, and catastrophism were the variables that appeared most frequently. (4) Conclusions: This review demonstrates that pain education in patients with cancer pain may produce effects such as decreased pain intensity and catastrophism. Knowledge about pain also seems to increase. However, no benefit was reported for patients’ overall quality of life. Therefore, more research is needed to clarify the effects of these interventions on the oncology population.

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Section: Resultsmentioning

confidence: 99%

Effectiveness of Therapeutic Education in Patients with Cancer Pain: Systematic Review and Meta-Analysis

González-Martín,

Aguilera-García,

Castellote-Caballero

et al. 2023

Cancers

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“…A pilot study involving patients with CPSP using a personalised eHealth self-management intervention demonstrated a significant improvement in pain-related functioning, physical functioning, and quality of life [39]. It concluded that personalised eHealth interventions appeared supportive for chronic pain management after breast cancer surgery but acknowledged that a large controlled clinical trial is needed to determine effectiveness.…”

Section: Interventions In Breast Cancer Follow-upmentioning

confidence: 99%

Managing chronic pain after breast cancer treatments: are web-based interventions the future?

Hartup,

Briggs

2024

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of the review Chronic post-treatment pain in breast cancer affects a high proportion of patients. Symptom burden and financial costs are increasingly impacting patients and healthcare systems because of improved treatments and survival rates. Supporting long-term breast cancer symptoms using novel methodology has been examined, yet few have explored the opportunity to utilise these interventions for prevention. This review aims to explore the need for, range of, and effectiveness of such interventions. Recent findings Three papers describe risk factors for chronic pain, with six recent papers describing the use of interventions for acute pain in the surgical setting. The evidence for the effectiveness of these interventions to improve pain management in this setting is limited but tentatively positive. The results have to take into account the variation between systems and limited testing. Summary Multiple types of intervention emerged and appear well accepted by patients. Most assessed short-term impact and did not evaluate for reduction in chronic pain. Such interventions require rigorous effectiveness testing to meet the growing needs of post-treatment pain in breast cancer. A detailed understanding of components of web-based interventions and their individual impact on acute pain and chronic pain is needed within future optimisation trials. Their effectiveness as preventative tools are yet to be decided.

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“…PNE covers topics such as acute versus chronic pain, the purpose of acute pain, the origins of acute pain, the transition to chronic pain and potential factors that sustain chronic pain, explained from a biopsychosocial view rather than a pure patho-anatomical output, and as a consequence, patients’ illness perceptions also change to the biopsychosocial perspective 23 24. Previous single-arm studies using PNE in BCSs showed positive results on central sensitisation symptoms25 26 and pain-related function and quality of life,26 whereas results in a large randomised controlled trial comparing PNE combined with physical activity with biomedically focused education did not find any significant differences in different pain-related outcomes 27. However, the latter trial was conducted in BCSs who were not preselected for having significant pain, which might explain the absence of an added value of the respective PNE-based intervention 27.…”

Section: Introductionmentioning

confidence: 99%

Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial)

Roose,

Huysmans,

Leysen

et al. 2024

BMJ Open

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IntroductionCurrent treatments for pain in breast cancer survivors (BCSs) are mostly biomedically focused rather than biopsychosocially driven. However, 22% of BCSs with pain are experiencing perceived injustice, which is a known predictor for adverse pain outcomes and opioid prescription due to increased maladaptive pain behaviour. Educational interventions such as pain neuroscience education (PNE) are suggested to target perceived injustice. In addition, motivational interviewing can be an effective behavioural change technique. This trial aims to examine whether perceived injustice-targeted PNE with the integration of motivational interviewing is superior to biomedically focused pain education in reducing pain after 12 months in BCS with perceived injustice and pain. In addition, improvements in quality of life, perceived injustice and opioid use are evaluated, and a cost-effectiveness analysis will finally result in a recommendation concerning the use of perceived injustice-targeted PNE in BCSs with perceived injustice and pain.Methods and analysisThis two-arm multicentre randomised controlled trial will recruit female BCS (n=156) with pain and perceived injustice. Participants will be randomly assigned to perceived injustice-targeted PNE or biomedically focused pain education in each centre. Both interventions include an online session, an information leaflet and three one-to-one sessions. The primary outcome (pain), secondary outcomes (quality of life, perceived injustice and outcomes for cost-effectiveness analysis) and explanatory outcomes (pain phenotyping, sleep, fatigue and cognitive-emotional factors) will be assessed at baseline and at 0, 6, 12 and 24 months postintervention using self-reported questionnaires online. Treatment effects over time will be evaluated using linear mixed model analyses. Additionally, a cost-utility analysis will be done from a healthcare payer and societal perspective.Ethics and disseminationThe ethical agreement was obtained from the Main Ethics Committee (B.U.N.1432020000068) at the University Hospital Brussels and all other participating hospitals. Study results will be disseminated through presentations, conferences, social media, press and journals.Trial registration numberNCT04730154.

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Feasibility and pilot testing of a personalized eHealth intervention for pain science education and self-management for breast cancer survivors with persistent pain: a mixed-method study

Cited by 14 publications

References 58 publications

Effectiveness of Therapeutic Education in Patients with Cancer Pain: Systematic Review and Meta-Analysis

Effectiveness of Therapeutic Education in Patients with Cancer Pain: Systematic Review and Meta-Analysis

Managing chronic pain after breast cancer treatments: are web-based interventions the future?

Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial)

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