A Pilot Evaluation of www.treatyourpain.com: An Interactive Empirically Based Intervention for the Management of Persistent Pain in Older Adults
AuthorMercer, Victoria Elizabeth
AdvisorO'Donohue, William T.
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In response to the growing chronic pain epidemic amongst adults age 60 and older (AGS Panel on Chronic Pain in Older Persons, 1998; Ardrey, Herr, Titler, Sorofman, & Schmitt, 2003; Morlin, et al., 2008), this study conducted a feasibility pilot of an innovative eHealth service in an effort to address the need to deliver a cost-effective, easily disseminateable, empirically based chronic pain treatment program to this often underserved population (Robinson, 2007; Landi, Onder, Cesari, et al., 2001; Won, Lapane, Gambassi, et al., 1999; Sengstaken & King, 1993). Consistent with the goals and procedures of Stage 1 behavioral treatment development research (McNamara et al., 2002; Rounsaville, Carroll, & Onken, 2001), this study had four primary aims: 1) develop the www.treatyourpain.com Internet treatment program; 2) evaluate hypothesized mechanisms of change by examining the extent to which the intervention enhanced individual coping skill acquisition and health promoting behavior; 3) evaluate the degree to which this program promoted improvements in overall pain related health status; and 4) assess participant acceptance of the treatment. Additional project goals included establishing the necessary sample size to conduct future randomized controlled trials and examine the cost-effectiveness of the intervention. To this end, we employed a randomized controlled feasibility trial design. The preliminary results of the study suggest that participants in the intervention experimental condition improved more significantly than those in the control condition on measures of overall health status, coping skill acquisition, and implementation of health promoting behaviors. This study provides preliminary evidence that an Internet-based chronic pain treatment program tailored specifically to the needs of older adults is both plausible and cost-effective as a first line treatment for this high utilizing population. The individuals who received the experimental condition reported significantly higher levels of satisfaction with and acceptance of the services they received compared to individuals in the control condition. Using a simple advertising strategy, the study was able to efficiently recruit enough web-traffic to meet our sample requirement. Additionally, once services began the study maintained an impressive 100% retention rate. Both of these particulars confirm that older adults are willing to seek out and receive psychological treatment over the Internet. Furthermore, providing tailored psychological treatment services over the Internet was found to offer substantial incremental cost effectiveness when compared to the estimated costs of face-to-face psychological care and the leading online pain website that served as this studies control. The implications from this study and future research directions are discussed.