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Randomized Controlled Trial
. 2023 Aug 25:25:e47284.
doi: 10.2196/47284.

Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial

Katrine Bostrøm  1   2 , Elin Børøsund  1   3 , Hilde Eide  1   4 , Cecilie Varsi  1   5 , Ólöf Birna Kristjansdottir  1   6   7 , Karlein M G Schreurs  8 , Lori B Waxenberg  9 , Karen E Weiss  10 , Eleshia J Morrison  10 , Hanne Stavenes Støle  1   11 , Milada Cvancarova Småstuen  12 , Audun Stubhaug  2   13   14 , Lise Solberg Nes  1   2   10
Affiliations
Randomized Controlled Trial

Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial

Katrine Bostrøm et al. J Med Internet Res. .

Abstract

Background: Chronic pain conditions involve numerous physical and psychological challenges, and while psychosocial self-management interventions can be of benefit for people living with chronic pain, such in-person treatment is not always accessible. Digital self-management approaches could improve this disparity, potentially bolstering outreach and providing easy, relatively low-cost access to pain self-management interventions.

Objective: This randomized controlled trial aimed to evaluate the short-term efficacy of EPIO (ie, inspired by the Greek goddess for the soothing of pain, Epione), a digital self-management intervention, for people living with chronic pain.

Methods: Patients (N=266) were randomly assigned to either the EPIO intervention (n=132) or a care-as-usual control group (n=134). Outcome measures included pain interference (Brief Pain Inventory; primary outcome measure), anxiety and depression (Hospital Anxiety and Depression Scale), self-regulatory fatigue (Self-Regulatory Fatigue 18 scale), health-related quality of life (SF-36 Short Form Health Survey), pain catastrophizing (Pain Catastrophizing Scale), and pain acceptance (Chronic Pain Acceptance Questionnaire). Linear regression models used change scores as the dependent variables.

Results: The participants were primarily female (210/259, 81.1%), with a median age of 49 (range 22-78) years and a variety of pain conditions. Analyses (n=229) after 3 months revealed no statistically significant changes for the primary outcome of pain interference (P=.84), but significant reductions in the secondary outcomes of depression (mean difference -0.90; P=.03) and self-regulatory fatigue (mean difference -2.76; P=.008) in favor of the intervention group. No other statistically significant changes were observed at 3 months (all P>.05). Participants described EPIO as useful (ie, totally agree or agree; 95/109, 87.2%) and easy to use (101/109, 92.7%), with easily understandable exercises (106/109, 97.2%).

Conclusions: Evidence-informed, user-centered digital pain self-management interventions such as EPIO may have the potential to effectively support self-management and improve psychological functioning in the form of reduced symptoms of depression and improved capacity to regulate thoughts, feelings, and behavior for people living with chronic pain.

Trial registration: ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104.

Keywords: acceptance and commitment therapy; chronic pain; cognitive behavioral therapy; digital health; efficacy; self-management.

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Conflict of interest statement

Conflicts of Interest: LSN is an unpaid board member of dHealth AS, a company eventually aiming to commercialize the EPIO program. All other authors declare no other conflicts of interest.

Figures

Figure 1
Figure 1
Example screenshots of the EPIO intervention program.
Figure 2
Figure 2
Recruitment and participant flow.
See this image and copyright information in PMC

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