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A behavioral cancer pain intervention: A randomized noninferiority trial comparing in‐person with videoconference delivery
Author(s) -
Kelleher Sarah A.,
Winger Joseph G.,
Dorfman Caroline S.,
Ingle Krista K.,
Moskovich Ashley A.,
Abernethy Amy P.,
Keefe Francis J.,
Samsa Greg P.,
Kimmick Gretchen G.,
Somers Tamara J.
Publication year - 2019
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5141
Subject(s) - medicine , randomized controlled trial , physical therapy , psychological intervention , cancer pain , distress , intervention (counseling) , cancer , clinical psychology , nursing
Objective Behavioral cancer pain interventions are efficacious for improving important pain outcomes; yet, traditional in‐person delivery limits patient access. This study compared videoconference‐delivered mobile health pain coping skills training (mPCST) to in‐person pain coping skills training (PCST‐traditional). Methods This study was a randomized, noninferiority trial with cancer patients. Participants (N = 178) were randomly assigned to four, 45‐minute sessions of mPCST or PCST‐traditional. Session content focused on evidence‐based cognitive and behavioral pain management skills. Assessments were completed at baseline, posttreatment, and 3‐month posttreatment, and included measures of primary intervention outcomes (ie, pain severity and pain interference) and secondary intervention outcomes (ie, physical symptoms, psychological distress, physical well‐being, and self‐efficacy). The main study aim tested whether mPCST was more accessible (defined as feasibility, acceptability, patient burden, and engagement) than PCST‐traditional. The second aim tested whether mPCST was noninferior to PCST‐traditional. Results mPCST demonstrated significantly greater feasibility (ie, attrition, adherence, and time to completion) than PCST‐traditional. Both groups reported similar patient burden and engagement as well as a high degree of acceptability. All intervention outcomes demonstrated noninferiority at posttreatment and, with the exception of physical symptoms, 3‐month posttreatment. Concerning the primary intervention outcomes, 95% CIs for the mean differences (d) were below the noninferiority margin of 1 for pain severity (posttreatment d = 0.09, 95% CI, −0.63‐0.81; 3 months d = −0.43 95% CI, −1.22‐0.36) and pain interference (posttreatment d = −0.11, 95% CI, −0.99‐0.76; 3 months d = −0.26 95% CI, −1.14‐0.62). Conclusion mPCST is highly accessible and noninferior to PCST‐traditional.