Telephone support improves early engagement with a web-based pain program – a randomized controlled trial investigating the effect of adjunct telephone support on adherence and outcomes of the “Reboot Online” pain management program (Preprint)

2021 ◽  
Author(s):  
Tania Gardner ◽  
Hila Haskelberg ◽  
Regina Schultz ◽  
Jill Newby ◽  
Jane Wheatley ◽  
...  
Keyword(s):  
Pain Management ◽  
Controlled Trial ◽  
Intervention Group ◽  
Management Program ◽  
Control Group ◽  
Telephone Support ◽  
Online Program ◽  
Randomized Controlled ◽  
Pain Management Program ◽  
Program Adherence

BACKGROUND Internet-based treatment programs present a solution for providing access to pain management for those unable to access clinic-based multidisciplinary pain programs. Attrition from internet interventions is a common issue. Clinician supported guidance can be an important feature in online interventions however the optimal level of therapist guidance and expertise required to improve adherence remains unclear. OBJECTIVE To evaluate whether augmenting the existing Reboot Online program with additional telephone support by a clinician, improves program adherence and effectiveness, relative to the online program alone METHODS A two-armed, CONSORT-compliant registered randomized controlled trial (RCT), with one-to-one group allocation was conducted. It compared an online multidisciplinary pain management program Reboot Online combined with telephone support (n=44), with Reboot Online alone (n=45) as the control group. Participants were recruited via online social media and existing THISWAYUP networks. The primary outcome for this study was adherence to the Reboot Online program. Adherence was quantified via three metrics; (i) completion of the program (ii) the number of participants who enrolled into the program, (iii) the number of participants who commenced the program. Data on adherence were collected automatically via the THIS WAY UP platform. Secondary measures of clinical effectiveness were also collected. RESULTS Reboot Online combined with telephone support had a positive effect on enrolment and commencement of the program compared to Reboot Online without telephone support. Significantly more participants from the Reboot Online plus telephone support group enrolled (93.2%) into the course compared to the control group (77.8%) (χ2 = 4.23, p = 0.04), Further, more participants from the intervention group commenced the course compared to the control group (90.9% versus 60.0% respectively, χ2 = 11.42, p = 0.001). Of those participants enrolled in the intervention group, 43.2% completed the course (19/44) and of those in the control group 31.1% completed the course (14/45). When considering the subgroup of those who commenced the program, there was no significant difference between the proportions of people who completed all 8 lessons in the intervention (47.5%) versus control groups (51.8%) (χ2 = 1.39, p = 0.24). CONCLUSIONS Telephone support improves participants’ registration, program commencement and engagement in early phase of the internet intervention; however, it did not appear to impact on overall course completion or efficacy. CLINICALTRIAL The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001076167), and the protocol was followed as per the registry. The study was approved by the Human Research Ethics Committee (2019/ETH08682) of St Vincent’s Hospital Sydney, Australia.

scholarly journals Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Lu Zhang ◽  
Howard L McLeod ◽  
Ke-Ke Liu ◽  
Wen-Hui Liu ◽  
Hang-Xing Huang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Pain Management ◽  
Cancer Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Scores

BACKGROUND Self-management of ambulatory cancer pain is full of challenges. Motivated by the need for better pain management, we developed a WeChat-supported platform, Medication Housekeeper (MediHK), to enhance communication, optimize outcomes, and promote self-management in the home setting. OBJECTIVE We conducted a randomized controlled trial to assess whether the joint physician-pharmacist team through MediHK would provide better self-management of ambulatory patients with cancer pain. METHODS Patients were randomly assigned to either an intervention group or control group. During the 4-week study period, the pharmacist would send 24-hour pain diaries daily, adverse drug reaction (ADR) forms every 3 days, and the Brief Pain Inventory form every 15 days to patients in the intervention group via MediHK. If a patient needed a change in drug/dosage or treatment of an ADR after the comprehensive review, the pharmacist would propose pharmacological interventions to the attending physician, who was then responsible for prescribing or adjusting pain medications. If no adjustments were needed, the pharmacist provided appropriate targeted education based on knowledge deficits. Patients in the control group received conventional care and did not receive reminders to fill out the forms. However, if the control group patients filled out a form via MediHK, the pain management team would review and respond in the same way as for the intervention group. The primary outcomes included pain intensity and pain interference in daily life. Secondary outcomes included patient-reported outcome measures, medication adherence, ADRs, and rehospitalization rates. RESULTS A total of 100 patients were included, with 51 (51%) in the intervention group and 49 (49%) in the control group. The worst pain scores, least pain scores, and average pain scores in the intervention group and the control group were statistically different, with median values of 4 (IQR 3-7) vs 7 (IQR 6-8; <i>P</i>=.001), 1 (IQR 0-2) vs 2 (IQR 1-3; <i>P</i>=.02), and 2 (IQR 2-4) vs 4 (IQR 3-5; <i>P</i>=.001), respectively, at the end of the study. The pain interference on patients' general activity, mood, relationships with others, and interests was reduced, but the difference was not statistically significant compared with the control group (<i>Ps</i>=.10-.76). The medication adherence rate increased from 43% to 63% in the intervention group, compared with an increase of 33% to 51% in the control group (<i>P</i>&lt;.001). The overall number of ADRs increased at 4 weeks, and more ADRs were monitored in the intervention group (<i>P</i>=.003). Rehospitalization rates were similar between the 2 groups. CONCLUSIONS The joint physician-pharmacist team operating through MediHK improved pain management. This study supports the feasibility of integrating the internet into the self-management of cancer pain. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900023075; https://www.chictr.org.cn/showproj.aspx?proj=36901

A randomized controlled trial of a peer-led pain management program for older adults: Baseline characteristics and preliminary results

2020 ◽  
Author(s):  
Mimi Mun Yee Tse ◽  
Yajie LI ◽  
Shuk Kwan Tang ◽  
Shamay Sheung Mei Ng ◽  
Xue Bai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Pain Management ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Management Program ◽  
Randomized Controlled ◽  
Pain Management Program ◽  
Pain Knowledge

Abstract Background Chronic pain is common among nursing home residents and they may have difficulty seeking out pain management strategies. Due to the limitation of healthcare resources, peer support model was proved with promising effect in managing chronic conditions. Methods It is a clustered randomized controlled trial. Peer-led pain management program was provided for the experimental group. Pain situation, depression, quality of life, non-drug strategies used and pain knowledge were measured. Results Totally 262 participants joined the study. Their overall pain score was 6.36. Leg was the most frequently reported site of pain and walking ability was interfered. Depression was also reported by the participants. The score for quality of life was 32.65 for physical component and 51.58 for mental component. The mean score for pain knowledge was 46.81 out of 100. No significant difference was shown between two groups at baseline. Discussion Severe pain intensity and low self-efficacy among the participants indicated it is necessary to provide pain management programs especially for this population. The frequency with strategies applied were significantly correlated with pain intensity, pain interference, depression, and quality of life. Pain knowledge also correlated significantly with some strategies.

scholarly journals Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial

10.2196/24555 ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. e24555
Author(s):  
Lu Zhang ◽  
Howard L McLeod ◽  
Ke-Ke Liu ◽  
Wen-Hui Liu ◽  
Hang-Xing Huang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Pain Management ◽  
Cancer Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Pain Scores

Background Self-management of ambulatory cancer pain is full of challenges. Motivated by the need for better pain management, we developed a WeChat-supported platform, Medication Housekeeper (MediHK), to enhance communication, optimize outcomes, and promote self-management in the home setting. Objective We conducted a randomized controlled trial to assess whether the joint physician-pharmacist team through MediHK would provide better self-management of ambulatory patients with cancer pain. Methods Patients were randomly assigned to either an intervention group or control group. During the 4-week study period, the pharmacist would send 24-hour pain diaries daily, adverse drug reaction (ADR) forms every 3 days, and the Brief Pain Inventory form every 15 days to patients in the intervention group via MediHK. If a patient needed a change in drug/dosage or treatment of an ADR after the comprehensive review, the pharmacist would propose pharmacological interventions to the attending physician, who was then responsible for prescribing or adjusting pain medications. If no adjustments were needed, the pharmacist provided appropriate targeted education based on knowledge deficits. Patients in the control group received conventional care and did not receive reminders to fill out the forms. However, if the control group patients filled out a form via MediHK, the pain management team would review and respond in the same way as for the intervention group. The primary outcomes included pain intensity and pain interference in daily life. Secondary outcomes included patient-reported outcome measures, medication adherence, ADRs, and rehospitalization rates. Results A total of 100 patients were included, with 51 (51%) in the intervention group and 49 (49%) in the control group. The worst pain scores, least pain scores, and average pain scores in the intervention group and the control group were statistically different, with median values of 4 (IQR 3-7) vs 7 (IQR 6-8; P=.001), 1 (IQR 0-2) vs 2 (IQR 1-3; P=.02), and 2 (IQR 2-4) vs 4 (IQR 3-5; P=.001), respectively, at the end of the study. The pain interference on patients' general activity, mood, relationships with others, and interests was reduced, but the difference was not statistically significant compared with the control group (Ps=.10-.76). The medication adherence rate increased from 43% to 63% in the intervention group, compared with an increase of 33% to 51% in the control group (P<.001). The overall number of ADRs increased at 4 weeks, and more ADRs were monitored in the intervention group (P=.003). Rehospitalization rates were similar between the 2 groups. Conclusions The joint physician-pharmacist team operating through MediHK improved pain management. This study supports the feasibility of integrating the internet into the self-management of cancer pain. Trial Registration Chinese Clinical Trial Registry ChiCTR1900023075; https://www.chictr.org.cn/showproj.aspx?proj=36901

scholarly journals A Web-Based Integrated Management Program for Improving Medication Adherence and Quality of Life, and Reducing Readmission in Patients With Atrial Fibrillation: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Hui-Ling Hsieh ◽  
Chi-Wen Kao ◽  
Shu-Meng Cheng ◽  
Yue-Cune Chang
Keyword(s):  
Medication Adherence ◽  
Integrated Management ◽  
Controlled Trial ◽  
Intervention Group ◽  
Management Program ◽  
Control Group ◽  
Web Based ◽  
Randomized Controlled ◽  
The Web

BACKGROUND Atrial fibrillation (AF) is related to a variety of chronic diseases and life-threatening complications. It is estimated that by 2050, there will be 72 million patients with AF in Asia, of which 2.9 million will have AF-associated stroke. AF has become a major issue for health care systems. OBJECTIVE We aimed to evaluate the effects of a web-based integrated management program on improving coping strategies, medication adherence, and health-related quality of life (HRQoL) in patients with AF, and to detect the effect on decreasing readmission events. METHODS The parallel-group, single-blind, prospective randomized controlled trial recruited patients with AF from a medical center in northern Taiwan and divided them randomly into intervention and control groups. Patients in the intervention group received the web-based integrated management program, whereas those in the control group received usual care. The measurement tools included the Brief Coping Orientation to Problems Experienced (COPE) scale, Medication Adherence Rating Scale (MARS), the three-level version of the EuroQoL five-dimension self-report questionnaire (EQ-5D-3L), and readmission events 2 years after initiating the intervention. Data were collected at 4 instances (baseline, 1 month, 3 months, and 6 months after initiating the intervention), and analyzed with generalized estimating equations (GEEs). RESULTS A total of 231 patients were recruited and allocated into an intervention (n=115) or control (n=116) group. The mean age of participants was 73.08 (SD 11.71) years. Most participants were diagnosed with paroxysmal AF (171/231, 74%), and the most frequent comorbidity was hypertension (162/231, 70.1%). Compared with the control group, the intervention group showed significantly greater improvement in approach coping strategies, medication adherence, and HRQoL at 1, 3, and 6 months (all <i>P</i>&lt;.05). In addition, the intervention group showed significantly fewer readmission events within 2 years (OR 0.406, <i>P</i>=.03), compared with the control group. CONCLUSIONS The web-based integrated management program can significantly improve patients' coping strategy and medication adherence. Therefore, it can empower patients to maintain disease stability, which is a major factor in improving their HRQoL and reducing readmission events within 2 years. CLINICALTRIAL ClinicalTrials.gov NCT04813094; https://clinicaltrials.gov/ct2/show/NCT04813094.

scholarly journals Reboot Online: A Randomized Controlled Trial Comparing an Online Multidisciplinary Pain Management Program with Usual Care for Chronic Pain

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2385-2396 ◽  
Author(s):  
Jessica Smith ◽  
Steven G Faux ◽  
Tania Gardner ◽  
Megan J Hobbs ◽  
Mathew A James ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Controlled Trial ◽  
Management Program ◽  
Post Treatment ◽  
Face To Face ◽  
Randomized Controlled ◽  
Pain Management Program ◽  
Multidisciplinary Pain Management

Abstract Objective Chronic pain is a prevalent and burdensome condition. Reboot Online was developed to address treatment barriers traditionally associated with accessing face-to-face chronic pain management programs. It is a comprehensive multidisciplinary online treatment program, based on an existing and effective face-to-face multidisciplinary pain program (the Reboot program). Design & Participants A CONSORT-compliant randomized controlled trial was conducted, enrolling adults who had experienced pain for three months or longer. Methods Participants were randomly allocated to either an eight-lesson multidisciplinary pain management program, Reboot Online (N = 41), or to a usual care (UC) control group (N = 39). Clinical oversight was provided by a multidisciplinary team remotely, including physiotherapists and clinical psychologists. Participants were measured at baseline, post-treatment (week 16), and three-month follow-up (week 28). Results Intention-to-treat analyses revealed that Reboot Online was significantly more effective than UC at increasing pain self-efficacy (g = 0.69) at post-treatment, and these gains were maintained at follow-up. Similarly, Reboot Online was significantly more effective than UC on several secondary measures at post-treatment and follow-up, including movement-based fear avoidance and pain-related disability, but it did not significantly reduce pain interference or depression compared with UC. Clinician input was minimal, and adherence to Reboot Online was moderate, with 61% of participants (N = 25) completing all eight lessons. Conclusions Reboot Online presents a novel approach to multidisciplinary pain management and offers an accessible, efficacious alternative and viable treatment option for chronic pain management.

scholarly journals Pilot Trial of the Reboot Online Program: An Internet-Delivered, Multidisciplinary Pain Management Program for Chronic Pain

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Regina Schultz ◽  
Jessica Smith ◽  
Jill M. Newby ◽  
Tania Gardner ◽  
Christine T. Shiner ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Psychological Distress ◽  
Pain Management ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Treatment Options ◽  
Pilot Trial ◽  
Management Program ◽  
Online Program ◽  
Pain Management Program

Objectives. Chronic pain causes significant disability and psychological distress, but barriers often prevent people with pain from engaging in traditional face-to-face pain management programs. Accessible, feasible, and effective alternative treatment options are needed. Methods. A prospective, feasibility pilot study was conducted to trial a novel, multidisciplinary online pain management program: the “Reboot Online” program. Twenty participants experiencing pain of at least three months duration were recruited. All participants were enrolled in the “Reboot Online” program, consisting of eight online lessons completed over 16 weeks. Lessons incorporated multidisciplinary input from medical pain specialists, physiotherapists, and psychologists. Participants were assessed at pretreatment, posttreatment, and follow-up using a suite of outcome measures examining pain, disability, catastrophising, self-efficacy, mood, and psychological distress. Results. 13 participants completed the program (65% adherence). Following treatment, the participants had significantly improved scores on measures of pain-related disability, self-efficacy, catastrophising thoughts, acceptance of pain, symptoms of depression, and general psychological distress. These findings were retained at three months posttreatment. Participants also reported high levels of acceptability and satisfaction with the program. Discussion. This study provides pilot evidence for the feasibility, acceptability, and effectiveness of an online, multidisciplinary pain program: “Reboot Online.” Future investigations will focus on conducting a randomised controlled trial of this innovative and promising treatment for chronic pain. This trial is registered with ACTRN12615000660583.

scholarly journals An Exploration of the Effectiveness of a Peer-Led Pain Management Program (PAP) for Nursing Home Residents with Chronic Pain and an Evaluation of Their Experiences: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 17 (11) ◽  
pp. 4090
Author(s):  
Mimi Tse ◽  
Yajie Li ◽  
Shuk Kwan Tang ◽  
Shamay S. M. Ng ◽  
Xue Bai ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Pain Management ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Management Program ◽  
Randomized Controlled ◽  
Pain Management Program ◽  
Experimental Group

Background: 80% of nursing home residents have reported chronic pain, which is often accepted by older adults as part of aging. Peer support models are being used to help individuals manage their chronic conditions and overcome the challenges of limited healthcare resources. The aims of this study were: (i) to examine the effectiveness of a 12 week peer-led pain management program (PAP) for nursing home residents and (ii) to evaluate their experiences. Methods: A cluster randomized controlled trial (RCT) was used. The 12 week pain management program was provided for the experimental group. Outcomes were measured at three time points. The participants’ satisfaction and acceptance were evaluated by a semi-structured interview after the program was completed. Results: Pain self-efficacy, pain intensity, pain interference, pain knowledge, and depression levels improved after the completion of the 12 week peer-led PAP. The pain-intensity level reported at week 12 was significantly lower in the experimental group than in the control group. Semi-structured interviews showed that the nursing home residents were satisfied with the pain education that they received. Conclusions: The 12 week peer-led PAP appeared to improve the pain-related and psychological outcome measures in nursing home residents, and the feedback on the peer-led PAP from the nursing home residents was positive.

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