A digital health intervention to support patients with chronic pain during prescription opioid tapering: a pilot randomised controlled trial
Ali Gholamrezaei,
Michael R. Magee,
Amy G. McNeilage,
Leah Dwyer,
Alison Sim,
Manuela L. Ferreira,
Beth D. Darnall,
Timothy Brake,
Arun Aggarwal,
Meredith Craigie,
Irina Hollington,
Paul Glare,
Claire E. Ashton-James
Affiliations
Ali Gholamrezaei
a Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Michael R. Magee
a Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Amy G. McNeilage
a Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Leah Dwyer
c Consumer Advisory Group, Painaustralia, Deakin, Victoria, Australia
Alison Sim
a Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Manuela L. Ferreira
d Sydney Musculoskeletal Health, Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Beth D. Darnall
e Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA
Timothy Brake
f Pain Management Centre, Royal Prince Alfred Hospital, University of Sydney, Sydney, New South Wales, Australia
Arun Aggarwal
f Pain Management Centre, Royal Prince Alfred Hospital, University of Sydney, Sydney, New South Wales, Australia
Meredith Craigie
g Pain Management Unit, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia
Irina Hollington
g Pain Management Unit, The Queen Elizabeth Hospital, The University of Adelaide, Adelaide, South Australia, Australia
Paul Glare
a Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Claire E. Ashton-James
a Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Abstract. Introduction:. Recent changes in opioid prescribing guidelines have led to an increasing number of patients with chronic pain being recommended to taper. However, opioid tapering can be challenging, and many patients require support. Objectives:. We evaluated the feasibility, acceptability, and potential efficacy of a codesigned digital health intervention to support patients with chronic pain during voluntary prescription opioid tapering. Methods:. In a pilot randomised controlled trial, participants received a psychoeducational video and 28 days of text messages (2 SMS/day) in addition to their usual care (intervention) or usual care alone (control). The feasibility, acceptability, and potential efficacy of the intervention were evaluated. The primary outcome was opioid tapering self-efficacy. Secondary outcomes were pain intensity and interference, anxiety and depression symptom severity, pain catastrophising, and pain self-efficacy. Results:. Of 28 randomised participants, 26 completed the study (13 per group). Text message delivery was high (99.2%), but fidelity of video delivery was low (57.1%). Most participants rated the messages as useful, supportive, encouraging, and engaging; 78.5% would recommend the intervention to others; and 64.2% desired a longer intervention period. Tapering self-efficacy (Cohen d = 0.74) and pain self-efficacy (d = 0.41) were higher, and pain intensity (d = 0.65) and affective interference (d = 0.45) were lower in the intervention group at week 4. Conclusion:. First evidence supports the feasibility, acceptability, and potentially efficacy of a psychoeducational video and SMS text messaging intervention to support patients with chronic pain during voluntary prescription opioid tapering. Definitive trials with longer intervention duration are warranted.
