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A randomized controlled evaluation of an online chronic pain self management program
Open accessAbstract
Internet-based educational and therapeutic programs (e-health applications) are becoming increasingly popular for a variety of psychological and physical disorders. We tested the efficacy of an online Chronic Pain Management Program, a comprehensive, fully self-directed and self-paced system that integrates social networking features and self-management tools into an interactive learning environment. Of 305 adult participants (196 women, 109 men), a total of 162 individuals with chronic pain were randomly assigned unsupervised access to the program for approximately 6 weeks; 143 were assigned to the wait-listed control group with treatment as usual. A comprehensive assessment was administered before the study and approximately 7 and 14 weeks thereafter. All recruitment, data collection, and participant involvement took place online. Participation was fully self-paced, permitting the evaluation of program effectiveness under real-world conditions. Intent-to-treat analysis that used linear growth models was used as the primary analytic tool. Results indicated that program utilization was associated with significant decreases in pain severity, pain-related interference and emotional burden, perceived disability, catastrophizing, and pain-induced fear. Further, program use led to significant declines in depression, anxiety, and stress. Finally, as compared to the wait-listed control group, the experimental group displayed a significant increase in knowledge about the principles of chronic pain and its management. Study limitations are considered, including the recognition that not all persons with chronic pain are necessarily good candidates for self-initiated, self-paced, interactive learning.
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“Another study, testing the effect of a no-therapist contact online intervention found positive effects on pain, catastrophizing, and disability for the intervention group [18].”
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Citations
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267
(2010) · Cited by 7,034
Self-citationImproving the Quality of Reporting of Randomized Controlled Trials: The CONSORT Statement
Begg, C. (1996) · JAMA · doi:10.1001/jama.1996.03540080059030 · Cited by 3,127
Webb, T. L., Joseph, J., Yardley, L., & Michie, S. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1376 · Cited by 2,517
The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview
Black, A. D., Car, J., Pagliari, C., Anandan, C., Cresswell, K., Bokun, T., McKinstry, B., Procter, R., Majeed, A., & Sheikh, A. (2011) · PLoS Medicine · doi:10.1371/journal.pmed.1000387 · Cited by 1,442
Pain and Behavioral Medicine: A Cognitive-Behavioral Perspective
Turk, D., Meichenbaum, D. H., Genest, M., & Berntzen, D. (1984) · Scandinavian Journal of Behaviour Therapy · doi:10.1080/16506078409455719 · Cited by 977
Internet-administered cognitive behavior therapy for health problems: a systematic review
Cuijpers, P., van Straten, A., & Andersson, G. (2008) · Journal of Behavioral Medicine · doi:10.1007/s10865-007-9144-1 · Cited by 555
Newman, M. G., Szkodny, L. E., Llera, S. J., & Przeworski, A. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.09.008 · Cited by 480
Melzack, R. (1990) · Scientific American · doi:10.1038/scientificamerican0290-27 · Cited by 429
Self‐Regulation Assessment and Intervention in Physical Health and Illness: A Review
Maes, S., & Karoly, P. (2005) · Applied Psychology · doi:10.1111/j.1464-0597.2005.00210.x · Cited by 389
Self-citationPalermo, T. M., Wilson, A. C., Peters, M., Lewandowski, A., & Somhegyi, H. (2009) · Pain · doi:10.1016/j.pain.2009.07.034 · Cited by 368
Turk, D. C., & Rudy, T. E. (1991) · Pain · doi:10.1016/0304-3959(91)90142-k · Cited by 311
Effectiveness of an Internet-based program for reducing risk factors for eating disorders.
Winzelberg, A. J., Eppstein, D., Eldredge, K. L., Wilfley, D., Dasmahapatra, R., Dev, P., & Taylor, C. B. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.2.346 · Cited by 291
Macea, D. D., Gajos, K., Daglia Calil, Y. A., & Fregni, F. (2010) · The Journal of Pain · doi:10.1016/j.jpain.2010.06.005 · Cited by 289
Effectiveness of an Internet-based program for reducing risk factors for eating disorders.
Winzelberg, A. J., Eppstein, D. L., Eldredge, K. L., Wilfley, D. E., Dasmahapatra, R., Dev, P., & Taylor, C. B. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.68.2.346 · Cited by 288
A controlled trial of self-help treatment of recurrent headache conducted via the Internet.
Ström, L., Pettersson, R., & Andersson, G. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.722 · Cited by 267 · cited 1×
“depression [31], anxiety [5], eating disorders [45], and addictive disorders [14], Internet-mediated or computer-aided behavior change interventions based on well-tested cognitive behavior therapy principles are currently seeing wider application for children and adults, with the type of available online help ranging…”
MethodTreatment of panic disorder via the internet: A randomized trial of a self-help program
Carlbring, P., Westling, B. E., Ljungstrand, P., Ekselius, L., & Andersson, G. (2001) · Behavior Therapy · doi:10.1016/s0005-7894(01)80019-8 · Cited by 262 · cited 1×
“depression [31], anxiety [5], eating disorders [45], and addictive disorders [14], Internet-mediated or computer-aided behavior change interventions based on well-tested cognitive behavior therapy principles are currently seeing wider application for children and adults, with the type of available online help ranging…”
MethodCelio, A. A., Winzelberg, A. J., Wilfley, D. E., Eppstein-Herald, D., Springer, E. A., Dev, P., & Taylor, C. B. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.4.650 · Cited by 251
Electronic diaries for monitoring chronic pain: 1-year validation study
Jamison, R. N., Raymond, S. A., Levine, J. G., Slawsby, E. A., Nedeljković, S. S., & Katz, N. P. (2001) · Pain · doi:10.1016/s0304-3959(00)00450-4 · Cited by 249
Geraghty, A. W. A., Wood, A. M., & Hyland, M. E. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.03.007 · Cited by 241 · cited 1×
“6%) was smaller than the average of 26% (yet ranging as high as 99%) reported in several reviews [3,16,35], and the effects for psychosocial outcomes (depression, anxiety, and stress) were more apparent than previously noted.”
BackgroundCan pain be managed through the Internet? A systematic review of randomized controlled trials
Bender, J. L., Radhakrishnan, A., Diorio, C., Englesakis, M., & Jadad, A. R. (2011) · Pain · doi:10.1016/j.pain.2011.02.012 · Cited by 223
Internet-enhanced management of fibromyalgia: A randomized controlled trial
Williams, D. A., Kuper, D., Segar, M., Mohan, N., Sheth, M., & Clauw, D. J. (2010) · Pain · doi:10.1016/j.pain.2010.08.034 · Cited by 210
Lorig, K. R., Laurent, D. D., Deyo, R. A., Marnell, M. E., Minor, M. A., & Ritter, P. L. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.7.792 · Cited by 206
A systematic review of internet-based therapy for the treatment of addictions
Gainsbury, S., & Blaszczynski, A. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.11.007 · Cited by 192
Moss-Morris, R., McAlpine, L., Didsbury, L. P., & Spence, M. J. (2010) · Psychological Medicine · doi:10.1017/s0033291709990195 · Cited by 187 · cited 2×
“Notable also is the use of self-management methods in an online format, with a literature that has progressed from case studies and uncontrolled feasibility testing [1,11] to randomized clinical trials [7,29,44].”
BackgroundMethodClinical essentials of pain management.
Gatchel, R. J. (2005) · American Psychological Association eBooks · doi:10.1037/10856-000 · Cited by 157
Barriers to Effective Cancer Pain Management
Yates, P. M., Edwards, H. E., Nash, R. E., Walsh, A. M., Fentiman, B. J., Skerman, H. M., & Najman, J. M. (2002) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(02)00387-1 · Cited by 156
Christiansen, S., Oettingen, G., Dahme, B., & Klinger, R. (2010) · Pain · doi:10.1016/j.pain.2009.12.015 · Cited by 149
Computer-Aided Psychological Treatments: Evolving Issues
Marks, I., & Cavanagh, K. (2009) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153538 · Cited by 133 · cited 1×
“depression [31], anxiety [5], eating disorders [45], and addictive disorders [14], Internet-mediated or computer-aided behavior change interventions based on well-tested cognitive behavior therapy principles are currently seeing wider application for children and adults, with the type of available online help ranging…”
Methode-Health and chronic pain management: Current status and developments
Keogh, E., Rosser, B. A., & Eccleston, C. (2010) · Pain · doi:10.1016/j.pain.2010.07.014 · Cited by 132 · cited 1×
“Thus, there has been a movement to supplement and extend established therapeutic and educational interventions for chronic pain with innovative, cost-effective, and empirically sound alternatives such as automated telephone services, progress monitoring via regular mail and e-mail, electronic diaries, video-based psyc…”
BackgroundpainACTION-Back Pain: A Self-Management Website for People with Chronic Back Pain
Chiauzzi, E., Pujol, L. A., Wood, M., Bond, K., Black, R., Yiu, E., & Zacharoff, K. (2010) · Pain Medicine · doi:10.1111/j.1526-4637.2010.00879.x · Cited by 130
Rosser, B. A., Vowles, K. E., Keogh, E., Eccleston, C., & Mountain, G. A. (2009) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2009.090116 · Cited by 103
Evaluation of WebEase: an epilepsy self-management Web site
DiIorio, C. K., Escoffery, C., McCarty, F., Yeager, K. A., Henry, T. R., Koganti, A., Reisinger, E. L., & Wexler, B. (2008) · Health Education Research · doi:10.1093/her/cyn012 · Cited by 89
Kiluk, B. D., Sugarman, D. E., Nich, C., Gibbons, C. J., Martino, S., Rounsaville, B. J., & Carroll, K. M. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10101443 · Cited by 86
Electronic Diaries as a Tool to Improve Pain Management: Is There Any Evidence?
Marceau, L. D., Link, C. L., Jamison, R. N., & Carolan, S. (2007) · Pain Medicine · doi:10.1111/j.1526-4637.2007.00374.x · Cited by 76
Ruehlman, L. S., Karoly, P., Newton, C., & Aiken, L. S. (2004) · Pain · doi:10.1016/j.pain.2004.09.037 · Cited by 52
Self-citationSelf-regulation training for chronic pain: Can it be done effectively by telemedicine?
Appel, P. R., Bleiberg, J., & Noiseux, J. (2002) · Telemedicine Journal and e-Health · doi:10.1089/15305620260507495 · Cited by 43
Automated telephone as an adjunct for the treatment of chronic pain: a pilot study
Naylor, M. R., Helzer, J. E., Naud, S. J., & Keefe, F. J. (2002) · Journal of Pain · doi:10.1054/jpai.2002.129563 · Cited by 43
Sauer-Zavala, S. E., Burris, J. L., & Carlson, C. R. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.06.008 · Cited by 38
Disease Management for Chronic Pain: Barriers of Program Implementation With Primary Care Physicians
Jamison, R. N., Gintner, L., Rogers, J. F., & Fairchild, D. G. (2002) · Pain Medicine · doi:10.1046/j.1526-4637.2002.02022.x · Cited by 36
Rosser, B. A., McCullagh, P. J., Davies, R. J., Mountain, G. A., McCracken, L. M., & Eccleston, C. (2011) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2010.0136 · Cited by 33
Ruehlman, L. S., Karoly, P., Newton, C., & Aiken, L. S. (2005) · Pain · doi:10.1016/j.pain.2005.09.001 · Cited by 32
Self-citationConsensus on outcome measures for chronic pain trials
McQuay, H. (2004) · Pain · doi:10.1016/j.pain.2004.10.019 · Cited by 32
Reducing Medical Costs and Improving Quality via Self-Management Tools
DeMonaco, H. J., & von Hippel, E. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040104 · Cited by 16
Can ‘ehealth’ technology deliver on its promise of pain management for all?
Eccleston, C. (2011) · Pain · doi:10.1016/j.pain.2011.05.004 · Cited by 15
PainAction.com: an interactive self-management website for chronic pain patients
Chiauzzi, E. J., Venuti, S. W., & Zacharoff, K. L. (2009) · Journal of Pain · doi:10.1016/j.jpain.2009.01.023 · Cited by 4
Flagged first, then by citations
1 of the 47 references couldn’t be matched to a known paper.
Cited by
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Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., Holmes-Rovner, M., Llewellyn-Thomas, H., Lyddiatt, A., Thomson, R., et al. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001431.pub5 · Cited by 6,685
Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014) · American Psychologist · doi:10.1037/a0035747 · Cited by 879
Decision aids for people facing health treatment or screening decisions
Stacey, D., Lewis, K. B., Smith, M., Carley, M. E., Volk, R. J., Douglas, E. E., Pacheco‐Brousseau, L., Finderup, J., Gunderson, J., Barry, M. J., et al. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001431.pub6 · Cited by 416
Multiple imputation as a flexible tool for missing data handling in clinical research
Enders, C. K. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.11.008 · Cited by 356
Self-citationMerolli, M., Gray, K. M., & Martin-Sanchez, F. J. (2013) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2013.04.010 · Cited by 320
Metadata
- Authors
- Ruehlman, L. S., Karoly, P., & Enders, C.
- Affiliations
- Goalistics (US)
- Arizona State University (US)
- Corresponding author
- Ruehlman, Linda S.
- Venue
- Pain
- Published
- 2012-02
- Volume
- 153
- Issue
- 2
- Pages
- 319-330
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC3514416
- OpenAlex
- W2013030216
- Semantic Scholar
- 65cbfec304942739a85e6107407cdfdc1a0bbf85
- Cited by
- 172
- References
- 47
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 9 · 2023: 14 · 2022: 20 · 2021: 7 · 2020: 15 · 2019: 17 · 2018: 11 · 2017: 11 · 2016: 12 · 2015: 15 · 2014: 13 · 2013: 8 · 2012: 4
- FWCI
- 9.41
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R44NS048743)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic pain, self-management, e-health, online intervention, pain catastrophizing, fear of pain, depression, anxiety, stress, pain knowledge, social networking, self-paced learning, program utilization
- MeSH terms
- Adult, Aged, Computer-Assisted Instruction, Female, Humans, Male, Middle Aged, Online Systems, Self Care, Software, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Chronic Pain
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