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Examination of an internet-delivered cognitive behavioural pain management course for adults with fibromyalgia: a randomized controlled trial

Friesen, Lindsay N.; Hadjistavropoulos, Heather D.; Schneider, Luke H.; Alberts, Nicole M.; Titov, Nikolai; Dear, Blake F.

doi: 10.1097/j.pain.0000000000000802
Research Paper
C

Fibromyalgia (FM) is a common and often debilitating chronic pain condition. Research shows that symptoms of depression and anxiety are present in up to 3 quarters of individuals with FM. Of concern, most adults with FM cannot access traditional face-to-face cognitive behavioural pain management programs, which are known to be beneficial. Given known difficulties with treatment access, the present study sought to explore the efficacy and acceptability of a previously developed Internet-delivered cognitive behavioural pain management course, the Pain Course, for adults with FM. The five-lesson course was delivered over 8 weeks and was provided with brief weekly contact, via telephone and secure email, with a guide throughout the course. Participants were randomized either to the Pain Course (n = 30) or to a waiting-list control group (n = 30). Symptoms were assessed at pre-treatment, post-treatment and 4-week follow-up. Completion rates (87%) and satisfaction ratings (86%) were high. Improvements were significantly greater in treatment group participants compared to waiting-list group participants on measures of FM (Cohen's d = 0.70; 18% reduction), depression (Cohen's d = 0.63-0.72; 20%-28% reduction), pain (Cohen's d = 0.87; 11% improvement) and fear of pain (Cohen's d = 1.61; 12% improvement). Smaller effects were also observed on measures of generalized anxiety and physical health. The changes were maintained at 4-week follow-up. The current findings add to existing literature and highlight the specific potential of Internet-delivered cognitive behavioural pain management programs for adults with FM, especially as a part of stepped-care models of care. Future research directions are described.

A guided Internet-delivered cognitive behavioural pain management course for fibromyalgia found improved fibromyalgia, depression, pain and fear of pain relative to waiting list control.

aDepartment of Psychology, University of Regina, Regina, SK, Canada

bDepartment of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA

ceCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia

Corresponding author. Address: Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada. Tel.: 306 585 5133; fax: 306 585 4772. E-mail address: heather.hadjistavropoulos@uregina.ca (H. D. Hadjistavropoulos).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received May 26, 2016

Received in revised form October 19, 2016

Accepted November 28, 2016

© 2017 International Association for the Study of Pain
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