Dear BF and colleagues compared a remote-delivered pain management program, the Pain Course, when delivered in online and workbook formats in a randomized control trial. The study included 178 patients assigned to one of the 2 groups: (1) an Internet Group (n=84) who were given secure accounts to the program in an online format; or (2) a Workbook Group (n=94) who were mailed workbook versions of the program. The content of both the programs was similar and consisted 5 core lessons.  The participants were encouraged to work through over an 8-week period, according to a prescribed timetable. All the participants were provided with weekly contact with a clinical psychologist through email and telephone throughout the program.

Significant improvements (avg. improvement) were seen in both the groups, in levels of disability (PDI: 16% vs 24%; RMDQ: 12% vs 15%), anxiety (GAD-7: 36% vs 26%), and depression (PHQ-9: 36% vs 36%) immediately post-treatment. Further improvements were observed in disability levels to 3-month follow-up, and improvements across the other primary outcomes were maintained until 12-month follow-up. High treatment completion rates and levels of satisfaction were reported in both the groups, and both groups required a similarly small amount of clinician contact per participant (M=74.85 minutes; SD=41.03).

These results highlight the public health potential of remote-delivered pain management programs, delivered in either workbook or online formats, as methods of increasing access to pain management.