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. 2021 Apr 20:25:100396.
doi: 10.1016/j.invent.2021.100396. eCollection 2021 Sep.

Internet-based treatment for vulvodynia (EMBLA) - Study protocol for a randomised controlled study

Andrea Hess Hess Engström  1   2 , Merit Kullinger  1   2 , Izabella Jawad  2 , Susanne Hesselman  2   3 , Monica Buhrman  4 , Ulf Högberg  2 , Alkistis Skalkidou  2
Affiliations

Internet-based treatment for vulvodynia (EMBLA) - Study protocol for a randomised controlled study

Andrea Hess Hess Engström et al. Internet Interv. .

Abstract

Background: Vulvodynia is defined as vulvar pain for at least 3 months without a clear cause. To the best of our knowledge, there are no trials investigating the effects of internet treatment using CBT (Cognitive behavioural therapy) treatment with Acceptance and Commitment Therapy (ACT) components for women with vulvodynia. The aim of this study is to examine the effects of such a guided internet-based intervention on provoked vulvar pain during the waiting period before clinical treatment.

Methods: We will randomise 52 patients to either guided internet-based intervention with CBT with (ACT) components or no intervention during the waiting period for treatment as usual. Online assessments are conducted at baseline, posttreatment, and at follow-up after 9 months. The primary outcome measure is provoked vulvar pain. Secondary outcomes are depression, anxiety, sexual function, and quality of life. Linear-mixed effect models will be used to assess the effect of the internet-based intervention on vulvar pain, pain acceptance, depression, anxiety, sexual function, and quality of life over time, by applying the intention-to-treat approach. Continuous data will be analysed with general linear models using intention-to-treat and also per protocol approaches to assess the effects of the intervention at different time points. Ordinal and binary data will be analysed with Mann Whitney's test, Fischer's exact test and multivariate logistic regression, respectively.

Discussion: As a randomised controlled trial with short- and long-term follow-up points, the EMBLA study intends to provide a novel and better understanding regarding the treatment of vulvodynia and the role of internet-based treatment as a complement to standard care for women suffering from vulvodynia. The effects of vulvodynia on pain, sexual function, quality of life, depression, and anxiety are investigated. The study's results are expected to be of value in the planning of clinical care in the medical area. High dropout rates and technical difficulties associated with using the platform are common in similar studies.

Trial registration number: NCT02809612.

Keywords: ACT, Acceptance and commitment therapy; Acceptance and commitment therapy; BAI, Beck Anxiety Inventory; CBT, Cognitive Behavioural therapy; CPAQ, Chronic Pain Acceptance questionnaire; EQ5-D, EuroQol-5-dimension questionnaire; ESSI, ENRICHD Social Support Instrument; FSDS-R, Female Sexual Distress Scale – Revised; FSFI, Female Sexual Function Index; Internet-based; LOCF, last observation carried forward; MADRS-S, Montgomery-Åsberg Depression Rating Scale; Randomised controlled trial; SWLS, Satisfaction with Life Scale; Vulvodynia; rDAS, Revised Dyadic Adjustment Scale.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Example of information module on the option of saying no to sexual acts.
Fig. 2
Fig. 2
Example of exercise module on the different steps for desensitisation exercises.
Fig. 3
Fig. 3
Flowchart of the study.
See this image and copyright information in PMC

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