Journal of Pain & Relief
Open Access

Abstract

Introduction: Approximately 20% of the population suffers from chronic pain with a huge health cost burden. Evidence suggests that a multidisciplinary pain program (MDPP) is effective for chronic pain patients. A MDPP consists of various approaches to help the patient learn about chronic pain, its complexities and the skills to self-manage the condition. The Department of Pain medicine at St. Vincent�?¢�?�?�?�?s Hospital, Sydney, has developed a MDPP; the Reboot Pain Management Program (RPMP). Attendance to such programs can be limited due to family/work commitments and/or location of residence such as rural patients. Existing online pain management programs have been shown to result in positive outcomes however mainly focus on CBT components and have little or no activity based modules. "Reboot Online" is based upon St. Vincent�?¢�?�?�?�?s Hospital�?¢�?�?�?�?s �?¢�?�?�?�?Reboot�?¢�?�?�?�? Pain Management Program (face-to-face service) and modelled on existing internet-delivered cognitive behaviour therapy (iCBT) programs successfully disseminated by the Clinical Research Unit for Anxiety and Depression (CRUfAD). The Reboot online program is unique in that it includes activity based components and a graded exercise program, alongside traditional CBT modules (including pacing, goal setting, activity planning, thought challenging, communication skills, reactivation and stress management). Aim: To evaluate the effectiveness of �?¢�?�?�?�?Reboot online�?¢�?�?�? within a randomised controlled trial of the program. Methods: Eighty participants who had self-reported chronic pain were enrolled into the trial and were randomly allocated to 1 of 2 study arms (1. Reboot online N=39, 2. usual care N=41). The program was delivered through the www.virtualclinic.org.au with 8 lessons being accessed by the participants over 16 weeks. Primary outcome measures included: Brief Pain Inventory, Pain Self-efficacy Questionnaire, Fear Avoidance Beliefs Questionnaire, Tampa Scale for Kinesophobia, Pain Catastrophising Scale, Chronic Pain Acceptance Questionnaire, depression and generalised distress (PHQ9 and K-10). Measures were collected at pre-treatment; post treatment and 3 months follow up time points. Results: Preliminary data analysis (paired sample t-test) has indicated that the intervention group showed significant change in measures of pain interference (P<0.001), pain related stress (P<0.0001), pain self-efficacy (P<0.001), fear avoidance beliefs (p<0.0001), kinesiophobia (P<0.0001), chronic pain acceptance (P<0.0001), depression (P<0.0001) and general distress (P<0.0001) in pre-to post treatment measures. Further data analysis including 3 months follow up measures will be conducted in November 2016 to ascertain if these improvements are maintained and compared between groups (or something similar). Conclusion: Reboot Online is a promising and effective approach offering a unique online multidisciplinary pain management program. Reboot Online offers a cost-effective and pragmatic alternative and adjunct to multidisciplinary face-to-face pain management programs; �?¢�?�?�?�?Reboot Online�?¢�?�?�? will provide access to a MDPP for those living in rural areas, those unable to attend a program onsite due to physical/psychological impairment or with family/work commitments, thus increasing the accessibility to health services for those in chronic pain. Health services may also be able to utilize this program to combat extensive waiting times, and reduce the expense of running face-to-face pain management programs.

Biography

Steven Faux is the Director of Sacred Heart Rehabilitation Service and Director of Pain at St. Vincent’s Hospital, Sydney. His research interests are in posttraumatic headache, early pain management in trauma particularly the elderly and the development of a telehealth multidisciplinary pain clinic and pain programs. He has just published the first Australian RCT in early rehabilitation and pain management following road trauma focusing on pain and activity outcomes. He has been interested in asylum seeker and refugee health for the last 3 years and is a regular visitor at many Detention centres.