An Internet-Based Cognitive-Behavioral Program, With Telephone Support, Improves Pain, Disability and Emotional Well-Being in Adults With Chronic Pain: Randomized Controlled Trial of the Pain Course With 2-Year Follow-Up.

In 30 seconds

This randomised controlled trial evaluated an internet-delivered, cognitive-behavioral Pain Course with clinician support in adults with chronic pain living in Ireland. Participants were assigned to the five-lesson, eight-week program or delayed access with usual care in the interim. At post-treatment, the program group improved more than the control group in pain-related disability, anxiety, depression, and average pain, with effect sizes (Cohen d) of .48-1.00. Benefits were maintained or improved at three months; among respondents, treatment effects were largely maintained at two years, although follow-up attrition was substantial.

Key findings

• At post-treatment, improvements in disability, anxiety, depression, and average pain were greater with the program than control (Cohen d =.48-1.00).
• Outcomes improved by 12% to 44%, with benefits maintained or improved at 3-month follow-up.
• At 2-year follow-up, treatment effects were largely maintained among respondents, but retention was 44% (n=29).
• Course completion was 80%, and over 80% of participants reported high treatment satisfaction.

Why it matters

The trial suggests that a supported online CBT program can improve several important chronic-pain outcomes, including disability and emotional well-being, compared with delayed access and usual care. Its reported durability among two-year respondents is encouraging, while substantial long-term attrition means those results should be interpreted cautiously. The findings add evidence for internet-based support as a potential way to deliver psychological pain management.

What to keep in mind

Substantial attrition at two-year follow-up limits confidence in the durability findings; only 29 participants (44% retention) responded at that time point.