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Self-Guided Online Cognitive Behavioral Strategies for Chemotherapy-Induced Peripheral Neuropathy: A Multicenter, Pilot, Randomized, Wait-List Controlled Trial.
J Pain 2018; 19(4):382-394JP

Abstract

The purpose of this pilot, parallel, randomized controlled trial was to examine the efficacy of a self-guided online cognitive and behaviorally-based pain management intervention (Proactive Self-Management Program for Effects of Cancer Treatment [PROSPECT]) to reduce "worst" pain for individuals with chronic painful chemotherapy-induced peripheral neuropathy (CIPN). Secondary outcomes included "average" pain, nonpainful CIPN symptom severity, impression of change, and pain interference. Sixty patients with chronic painful CIPN were recruited from 5 outpatient academic and community cancer centers. Patients were randomized in a 1:1 ratio to receive either 8 weeks of PROSPECT or usual care. A 7-day electronic "worst" pain intensity diary and standardized measures of pain interference, nonpainful CIPN symptom severity, impression of change, and "average" pain were administered pre/post intervention. Postintervention mean scores were evaluated between groups using analysis of covariance adjusting for baseline. Individuals who received the PROSPECT intervention (n = 19) had significantly greater improvements in "worst pain" compared with individuals receiving usual care (n = 19; P = .046, d = .58). There were no significant differences in mean scores between groups for the secondary outcomes (n = 42). A larger, adequately powered study testing the PROSPECT intervention is needed to determine if improvements in pain may be sustained, evaluate the effect of the intervention on the secondary outcomes, and identify mediators of pain intensity-related improvement.

PERSPECTIVE

This study explores the efficacy of an 8-week online cognitive behavioral pain management intervention for chronic painful CIPN. Intervention use resulted in greater improvements in "worst" pain than usual care alone. The findings provide preliminary support for the efficacy of a nonpharmacological intervention for chronic painful CIPN.

Authors+Show Affiliations

Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts. Electronic address: Robert_knoerl@DFCI.Harvard.edu.School of Nursing, University of Michigan, Ann Arbor, Michigan.School of Nursing, University of Michigan, Ann Arbor, Michigan.School of Medicine, University of Michigan, Ann Arbor, Michigan.School of Nursing, University of Michigan, Ann Arbor, Michigan.Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan.St. Joseph Mercy Hospital, Ann Arbor, Michigan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29229430

Citation

Knoerl, Robert, et al. "Self-Guided Online Cognitive Behavioral Strategies for Chemotherapy-Induced Peripheral Neuropathy: a Multicenter, Pilot, Randomized, Wait-List Controlled Trial." The Journal of Pain : Official Journal of the American Pain Society, vol. 19, no. 4, 2018, pp. 382-394.
Knoerl R, Smith EML, Barton DL, et al. Self-Guided Online Cognitive Behavioral Strategies for Chemotherapy-Induced Peripheral Neuropathy: A Multicenter, Pilot, Randomized, Wait-List Controlled Trial. J Pain. 2018;19(4):382-394.
Knoerl, R., Smith, E. M. L., Barton, D. L., Williams, D. A., Holden, J. E., Krauss, J. C., & LaVasseur, B. (2018). Self-Guided Online Cognitive Behavioral Strategies for Chemotherapy-Induced Peripheral Neuropathy: A Multicenter, Pilot, Randomized, Wait-List Controlled Trial. The Journal of Pain : Official Journal of the American Pain Society, 19(4), pp. 382-394. doi:10.1016/j.jpain.2017.11.009.
Knoerl R, et al. Self-Guided Online Cognitive Behavioral Strategies for Chemotherapy-Induced Peripheral Neuropathy: a Multicenter, Pilot, Randomized, Wait-List Controlled Trial. J Pain. 2018;19(4):382-394. PubMed PMID: 29229430.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-Guided Online Cognitive Behavioral Strategies for Chemotherapy-Induced Peripheral Neuropathy: A Multicenter, Pilot, Randomized, Wait-List Controlled Trial. AU - Knoerl,Robert, AU - Smith,Ellen M L, AU - Barton,Debra L, AU - Williams,David A, AU - Holden,Janean E, AU - Krauss,John C, AU - LaVasseur,Beth, Y1 - 2017/12/08/ PY - 2017/08/08/received PY - 2017/09/07/revised PY - 2017/11/27/accepted PY - 2017/12/13/pubmed PY - 2017/12/13/medline PY - 2017/12/13/entrez KW - Chronic pain KW - chemotherapy-induced peripheral neuropathy KW - cognitive-behavioral therapy KW - peripheral nervous system disease/chemically induced SP - 382 EP - 394 JF - The journal of pain : official journal of the American Pain Society JO - J Pain VL - 19 IS - 4 N2 - : The purpose of this pilot, parallel, randomized controlled trial was to examine the efficacy of a self-guided online cognitive and behaviorally-based pain management intervention (Proactive Self-Management Program for Effects of Cancer Treatment [PROSPECT]) to reduce "worst" pain for individuals with chronic painful chemotherapy-induced peripheral neuropathy (CIPN). Secondary outcomes included "average" pain, nonpainful CIPN symptom severity, impression of change, and pain interference. Sixty patients with chronic painful CIPN were recruited from 5 outpatient academic and community cancer centers. Patients were randomized in a 1:1 ratio to receive either 8 weeks of PROSPECT or usual care. A 7-day electronic "worst" pain intensity diary and standardized measures of pain interference, nonpainful CIPN symptom severity, impression of change, and "average" pain were administered pre/post intervention. Postintervention mean scores were evaluated between groups using analysis of covariance adjusting for baseline. Individuals who received the PROSPECT intervention (n = 19) had significantly greater improvements in "worst pain" compared with individuals receiving usual care (n = 19; P = .046, d = .58). There were no significant differences in mean scores between groups for the secondary outcomes (n = 42). A larger, adequately powered study testing the PROSPECT intervention is needed to determine if improvements in pain may be sustained, evaluate the effect of the intervention on the secondary outcomes, and identify mediators of pain intensity-related improvement. PERSPECTIVE: This study explores the efficacy of an 8-week online cognitive behavioral pain management intervention for chronic painful CIPN. Intervention use resulted in greater improvements in "worst" pain than usual care alone. The findings provide preliminary support for the efficacy of a nonpharmacological intervention for chronic painful CIPN. SN - 1528-8447 UR - https://www.unboundmedicine.com/medline/citation/29229430/Self_Guided_Online_Cognitive_Behavioral_Strategies_for_Chemotherapy_Induced_Peripheral_Neuropathy:_A_Multicenter_Pilot_Randomized_Wait_List_Controlled_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1526-5900(17)30786-1 DB - PRIME DP - Unbound Medicine ER -