A Controlled Pilot Trial of PainTracker Self-Manager, a Web-Based Platform Combined With Patient Coaching, to Support Patients' Self-Management of Chronic Pain

Mark Sullivan; Dale J Langford; Pamela Stitzlein Davies; Christine Tran; Roger Vilardaga; Gifford Cheung; Daisy Yoo; Justin McReynolds; William B Lober; David Tauben; Kevin E Vowles

doi:10.1016/j.jpain.2018.03.009

A Controlled Pilot Trial of PainTracker Self-Manager, a Web-Based Platform Combined With Patient Coaching, to Support Patients' Self-Management of Chronic Pain

J Pain. 2018 Sep;19(9):996-1005. doi: 10.1016/j.jpain.2018.03.009. Epub 2018 Mar 29.

Authors

Affiliations

¹ Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington. Electronic address: sullimar@uw.edu.
² Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
³ School of Nursing, University of Washington, Seattle, Washington.
⁴ Center for Addiction Science and Technology, Duke University, Durham, North Carolina.
⁵ Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington.
⁶ Department of Information Science, University of Washington, Seattle, Washington.
⁷ Departments of Biobehavioral Nursing and Health Systems, Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington.
⁸ Division of Pain Medicine, Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
⁹ Department of Psychology, University of New Mexico, Albuquerque, New Mexico.

Abstract

The objective of this study was to develop and pilot test a chronic pain empowerment and self-management platform, derived from acceptance and commitment therapy, in a pain specialty setting. A controlled, sequential, nonrandomized study design was used to accommodate intervention development and to test the efficacy of the PainTracker Self-Manager (PTSM) intervention (Web-based educational modules and outcome tracking combined with tailored patient coaching sessions and provider guidance). Generalized estimating equations evaluated changes over time (baseline, 3 months, 6 months) in pain self-efficacy (primary outcome), chronic pain acceptance (activity engagement and pain willingness), perceived efficacy in patient-provider interactions, pain intensity and interference, and overall satisfaction with pain treatment (secondary outcomes) between intervention (n = 48) and usual care control groups (n = 51). The full study sample (N = 99) showed greater improvements over time (significant Group × Time interactions) in pain self-efficacy and satisfaction with pain treatment. Among study completers (n = 82), greater improvement in activity engagement as well as pain intensity and interference were also observed. These preliminary findings support the efficacy of the PTSM intervention in a pain specialty setting. Further research is needed to refine and expand the PTSM intervention and to test it in a randomized trial in primary care settings.

Perspective: We developed a Web-based patient empowerment platform that combined acceptance and commitment therapy-based educational modules and tailored coaching sessions with longitudinal tracking of treatments and patient-reported outcomes, named PTSM. Pilot controlled trial results provide preliminary support for its efficacy in improving pain self-efficacy, activity engagement, pain intensity and interference, and satisfaction with pain treatment.

Keywords: Acceptance and commitment therapy; health coaching; patient empowerment; patient-reported outcomes.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Acceptance and Commitment Therapy / methods*
Adolescent
Adult
Aged
Chronic Pain*
Female
Humans
Internet
Male
Middle Aged
Pain Management / methods*
Patient Education as Topic / methods*
Patient Reported Outcome Measures
Pilot Projects
Self-Management / methods*
Young Adult

Grants and funding

R00 DA037276/DA/NIDA NIH HHS/United States