Internet-delivered mindfulness-based cognitive therapy (iMBCT) for chronic pain symptom management in adults: A pilot randomized controlled trial

The purpose of this pilot randomized controlled trial was to examine the feasibility of an internet delivered, self-directed mindfulness-based cognitive therapy (iMBCT) program compared to a delayed treatment (DT) control. This trial employed a 2-group parallel (1:1), design and was pre-registered (ANZCTR Identifier: 12623000833662). Participants were N = 48 adults with chronic pain, randomized into either the 4-week iMBCT program or the DT control. The feasibility indicators were treatment engagement, study retention, treatment acceptability, and at least a small within-condition pre-to post-treatment effect size change in pain intensity or interference. The primary outcome was change in pain intensity, and secondary outcomes were pain interference, depression, sleep disturbance, and positive and negative affect at post-treatment/DT (primary endpoint). A high degree of engagement with iMBCT was found, with participants reporting it acceptable and of benefit; retention rate (88%) was high. Within iMBCT, a small-to-medium effect size improvement in pain interference (p =.031, d = 0.48) was found, and change in pain intensity was small (p =.347, d =.20). Small-to-medium changes were found for the other secondary outcomes within iMBCT. Small-to-less than small effect sizes were observed within DT. These preliminary findings indicate iMBCT is a feasible, tolerable, and acceptable treatment for chronic pain, and may result in meaningful improvements in pain interference. Taken together, the results suggest iMBCT may have the capacity to overcome access barriers and provide individuals with chronic pain a much needed, evidence-based treatment to enhance pain self-management. Perspective: This article presents the feasibility findings of an internet delivered, self-directed mindfulness-based cognitive therapy for chronic pain program. This novel digital platform may represent a scalable solution to increase access to critically needed chronic pain management services.