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Feasibility randomized‐controlled trial of online Acceptance and Commitment Therapy for patients with complex chronic pain in the United Kingdom
Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Psychol Sect, London, England; Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England.
Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Psychol Sect, London, England.
Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England.
Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England.
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2018 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 22, no 8, p. 1473-1484Article in journal (Refereed) Published
Abstract [en]

Background: Acceptance and Commitment Therapy (ACT) has growing support for chronic pain. However, more accessible treatment delivery is needed. This study evaluated the feasibility of online ACT for patients with complex chronic pain in the United Kingdom to determine whether a larger trial is justified.

Methods: Participants with chronic pain and clinically meaningful disability and distress were randomly assigned to ACT online plus specialty medical pain management, or specialty medical management alone. Participants completed questionnaires at baseline, and 3‐ and 9‐month post‐randomization. Primary feasibility outcomes included recruitment, retention and treatment completion rates. Secondary outcomes were between‐groups effects on treatment outcomes and psychological flexibility.

Results: Of 139 potential participants, 63 were eligible and randomized (45% recruitment rate). Retention rates were 76–78% for follow‐up assessments. Sixty‐one per cent of ACT online participants completed treatment. ACT online was less often completed by employed (44%) compared to unemployed (80%) participants. Fifty‐six per cent of ACT online participants rated themselves as ‘much improved’ or better on a global impression of change rating, compared to only 20 per cent of control participants. Three‐month effects favouring ACT online were small for functioning, medication and healthcare use, committed action and decentring, medium for mood, and large for acceptance. Small‐to‐medium effects were maintained for functioning, healthcare use and committed action at 9 months.

Conclusions: Online ACT for patients with chronic pain in the United Kingdom appears feasible to study in a larger efficacy trial. Some adjustments to treatment and trial procedures are warranted, particularly to enhance engagement among employed participants.

Significance: This study supports the feasibility of online Acceptance and Commitment Therapy for chronic pain in the United Kingdom and a larger efficacy trial. Refinements to treatment delivery, particularly to better engage employed patients, may improve treatment completion and outcomes.

Place, publisher, year, edition, pages
2018. Vol. 22, no 8, p. 1473-1484
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:uu:diva-372235DOI: 10.1002/ejp.1236ISI: 000441435800010PubMedID: 29704880OAI: oai:DiVA.org:uu-372235DiVA, id: diva2:1275543
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-05-27Bibliographically approved

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