A randomized controlled trial of an I nternet‐based cognitive–behavioural intervention for non‐specific chronic pain: An effectiveness and cost‐effectiveness study

Maaike J. de Boer · Gerbrig J. Versteegen · Karin Marianne Vermeulen · Robert Sanderman · Michel M. R. F. Struys

51 citations0/0 files storedEuropean Journal of Pain

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Digital Mental Health Interventions Musculoskeletal pain and rehabilitation Pain Management and Treatment

Abstract

BACKGROUND: Cognitive-behavioural treatment can nowadays be delivered through the Internet. This form of treatment can have various advantages with regard to availability and accessibility. Previous studies showed that Internet-based treatment for chronic pain is effective compared to waiting-list control groups. METHODS: We conducted a randomized controlled trial comparing an Internet-based cognitive-behavioural intervention with e-mail therapist contact to a face-to-face cognitive-behavioural group intervention. Of the 72 participants who were randomly assigned to an Internet or a group course, 50 participants completed the intervention. Participants were assessed at baseline (T0), immediately after the 7-week course (T1) and at the booster session 2 months later (T2). Pain-related catastrophizing was the primary outcome measure. Pain intensity, fatigue, pain-related interference, locus of control, pain coping, global health-related quality of life and medical expenses were secondary outcome variables. RESULTS: Significant improvement was found on catastrophizing, pain coping, locus of control and aspects of global health-related quality of life in both the Internet and the group courses directly after the course and at the booster session. Pain intensity was improved in both courses at the booster session. At T2, improvement in catastrophizing, pain intensity, pain coping and some quality of life dimensions was significantly greater in completers of the Internet course than in the group course. Furthermore, the Internet course was cost-effective compared to the group course. CONCLUSIONS: We conclude that the Internet-based cognitive-behavioural intervention was at least as effective as the face-to-face group intervention and, on some outcome measures appeared to be even more effective.

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References

2001The Revised CONSORT Statement for Reporting Randomized Trials: Explanation and Elaboration 2006Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis 1996Psychometric qualities of the rand 36-item health survey 1.0: A multidimensional measure of general health status 2004Treatment of panic disorder: live therapy vs. self-help via the Internet 2007Internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years old: a randomized controlled clinical trial 2010The Efficacy of Web-Based Cognitive Behavioral Interventions for Chronic Pain: A Systematic Review and Meta-Analysis 2011Can pain be managed through the Internet? A systematic review of randomized controlled trials

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