Effectiveness of an online-based acceptance and commitment therapy for chronic pain: a three-armed RCT

Abstract

Background: Internet interventions might be an effective way to overcome treatment barriers of traditional face-to-face pain interventions. This study aims to investigate the effectiveness of a guided and unguided acceptance- and commitment-therapy-based online-intervention for persons with chronic pain (ACTonPain). Method: In this pragmatic three-armed RCT with 300 participants, the programs ACTonPain guided and unguided are compared to a waiting list control group. ACTonPain consists of 7 modules that should be processed weekly. Assessments took place before, 9 weeks, and 6 months after randomisation. The primary outcome is pain impairment (Multidimensional Pain Inventory, MPI). Secondary outcomes are physical and emotional functionality (PHQ-9, GAD-7), pain intensity (NRS) and ACT-related variables (FAH-II, CPAQ). Findings: Preliminary data (n = 68; post-9-weeks) showed greater improvements for the scales MPI (MD: 1:16; SD: .25), BPI (MD: 2:24; SD: .57), PHQ-9 (MD: 4.98; SD 1.45) and CPAQ (MD: 27.76; SD 4.73) in ACTonPain guided compared to the waitlist (p = .05). Even though the scales FAH-II (MD 3.57; SD: 2.1), GAD-7 (MD2.81; SD: 1.23) and NRS (MD: 1:24; SD: .39) yielded positive effects, these effects were not significant. ACTonPain unguided also showed positive, but lower effects than ACTonPain guided. Discussion: The present study contributes to the evidence-base for online-based pain interventions and provides central information on the treatment success in relation to the intervention´s level of guidance. In the presentation, the final post and follow-up results (recruitment completed; data cleaning in progress) of this large scale trial will be presented.