Telehealth Pain Self-Management for Employed Adults
Efficacy of a Telehealth Pain Self-Management Intervention in Employed Adults With Physical Disability: A Randomized Controlled Trial
What it found
The main measure showed a statistically significant benefit.
| Measure | Estimate | 95% CI | p |
|---|---|---|---|
| Change in Pain Interference | Mean Difference (Net) -2.7 | 0.004 |
Statistical analysis as posted on ClinicalTrials.gov.
What was tested
Treatment tested
- E-TIPS
Results by group
Change in Pain Interference
Baseline (week 0) and 12 weeks (post-treatment)
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| E-TIPS | -4.0 T-score | -8.5–0.1 | 102 |
| Usual Care | -1.3 T-score | -5–2 | 100 |
E-TIPS
Usual Care
p = 0.004; Mean Difference (Net) -2.7
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| E-TIPS | 102 | 1 (1.0%) | 0 |
| Usual Care | 100 | 0 (0.0%) | 0 |
As posted on ClinicalTrials.gov. Serious adverse events include any serious health event during the trial, whether or not the treatment caused it.
What it measured
Main measures
Change in Pain Interference
Baseline (week 0) and 12 weeks (post-treatment)
PainQuality of life (reported by participants)
Other measures (2)
Change in Pain Self-efficacy
Baseline (week 0) and 12 weeks (post-treatment)
PainQuality of life (reported by participants)Change in Average Pain Intensity
Baseline (week 0) and 12 weeks (post-treatment)
Pain
Who could take part
MS (type not specified) · 18 and over
Show the full criteria
Inclusion criteria
* 18 years of age or older * Self-reported physical disability * Chronic pain defined as daily pain of ≥ 3 months duration and ≥ 3 average pain intensity in the past week on a 0-10 numerical rating scale * Experiences pain for more than 45 out of the past 90 days (defined as 50% of the time or greater) * Reads, speaks, and understands English * Has access to and is able to communicate over the telephone with our without assistive devices * Is employed, working 15-20 hours per week or more, on average, or earning in excess of substantial gainful activity (approximately $1200/month) We will enroll individuals with a range of physical disabilities to maximize the generalizability of the results, because there is no evidence that the type of disability affects responsiveness to the proposed treatment
Exclusion criteria
* Under the age of 18 * Cannot read, speak, or understand English * No self-reported physical disability * Currently unemployed * Plans to retire or leave employment within the study period * Working fewer than 15-20 hours per week, on average, and earning less than approximately $1200 per month * Cannot communicate or complete assessments over the phone or internet * Chronic pain defined as daily pain of ≤ 3 months duration and ≤ 3 average pain intensity in the past week on a 0-10 numerical rating scale * Experiences pain for fewer than 45 out of the past 90 days (defined as 50% of the time or less) * Currently participating in another pain study or cognitive behavioral therapy (CBT) study
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
The E-TIPS trial will evaluate an evidence-based, telehealth pain self-management intervention compared to standard care (a waitlist) for chronic pain in adults with physical disabilities who are employed. Participants from anywhere in the US will be randomized to either E-TIPS, a cognitive-behavioral pain self-management intervention delivered by telephone, or a waitlist control. Outcomes, including pain interference, will be assessed at baseline, mid-treatment, post-treatment, and 6-month follow up.
Papers
Background
Ehde DM, Jensen MP, Engel JM, Turner JA, Hoffman AJ, Cardenas DD. Chronic pain secondary to disability: a review. Clin J Pain. 2003 Jan-Feb;19(1):3-17. doi: 10.1097/00002508-200301000-00002.Background
Dijkers M, Bryce T, Zanca J. Prevalence of chronic pain after traumatic spinal cord injury: a systematic review. J Rehabil Res Dev. 2009;46(1):13-29.Background
Ehde DM, Czerniecki JM, Smith DG, Campbell KM, Edwards WT, Jensen MP, Robinson LR. Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. Arch Phys Med Rehabil. 2000 Aug;81(8):1039-44. doi: 10.1053/apmr.2000.7583.Background
Krause JS, Cao Y, Clark JMR. Pain Intensity, Interference, and Medication Use After Spinal Cord Injury: Association With Risk of Mortality After Controlling for Socioeconomic and Other Health Factors. Arch Phys Med Rehabil. 2017 Dec;98(12):2464-2470. doi: 10.1016/j.apmr.2017.05.024. Epub 2017 Jun 23.Background
Negre-Pages L, Regragui W, Bouhassira D, Grandjean H, Rascol O; DoPaMiP Study Group. Chronic pain in Parkinson's disease: the cross-sectional French DoPaMiP survey. Mov Disord. 2008 Jul 30;23(10):1361-9. doi: 10.1002/mds.22142.Background
Franklin GM, Wickizer TM, Coe NB, Fulton-Kehoe D. Workers' compensation: poor quality health care and the growing disability problem in the United States. Am J Ind Med. 2015 Mar;58(3):245-51. doi: 10.1002/ajim.22399. Epub 2014 Oct 20.Background
Alschuler KN, Ehde DM, Jensen MP. The co-occurrence of pain and depression in adults with multiple sclerosis. Rehabil Psychol. 2013 May;58(2):217-21. doi: 10.1037/a0032008.Background
Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. J Pain. 2011 Sep;12(9):964-73. doi: 10.1016/j.jpain.2011.03.003. Epub 2011 Jun 16.Background
O'Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH. Pain associated with multiple sclerosis: systematic review and proposed classification. Pain. 2008 Jul;137(1):96-111. doi: 10.1016/j.pain.2007.08.024. Epub 2007 Oct 24.Background
Warms CA, Turner JA, Marshall HM, Cardenas DD. Treatments for chronic pain associated with spinal cord injuries: many are tried, few are helpful. Clin J Pain. 2002 May-Jun;18(3):154-63. doi: 10.1097/00002508-200205000-00004.
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History
Started
Mar 2020
Main results due
Sept 2023
Finished
Mar 2024
Results posted
Jan 2025