Self-Guided Online Cognitive Behavioral Strategies for Chemotherapy-Induced Peripheral Neuropathy: A Multicenter, Pilot, Randomized, Wait-List Controlled Trial

被引:34
作者
Knoerl, Robert [1 ]
Smith, Ellen M. L. [2 ]
Barton, Debra L. [2 ]
Williams, David A. [3 ]
Holden, Janean E. [2 ]
Krauss, John C. [4 ]
LaVasseur, Beth [5 ]
机构
[1] Dana Farber Canc Inst, Phyllis F Cantor Ctr Res Nursing & Patient Care S, 450 Brookline Ave, Boston, MA 02215 USA
[2] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Sch Med, Ann Arbor, MI USA
[4] Univ Michigan, Comprehens Canc Ctr, Ann Arbor, MI 48109 USA
[5] St Joseph Mercy Hosp, Ann Arbor, MI 48104 USA
基金
美国国家卫生研究院;
关键词
Chronic pain; chemotherapy-induced peripheral neuropathy; cognitive-behavioral therapy; peripheral nervous system disease/chemically induced; QUALITY-OF-LIFE; PAIN CLINICAL-TRIALS; ASSAY SENSITIVITY; PREFRONTAL CORTEX; OUTCOME MEASURES; GRAY-MATTER; THERAPY; INTENSITY; RELIABILITY; PERSISTENCE;
D O I
10.1016/j.jpain.2017.11.009
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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. (C) 2017 by the American Pain Society
引用
收藏
页码:382 / 394
页数:13
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