Reboot Online: A Randomized Controlled Trial Comparing an Online Multidisciplinary Pain Management Program with Usual Care for Chronic Pain

Pain Med. 2019 Dec 1;20(12):2385-2396. doi: 10.1093/pm/pnz208.

Abstract

Objective: Chronic pain is a prevalent and burdensome condition. Reboot Online was developed to address treatment barriers traditionally associated with accessing face-to-face chronic pain management programs. It is a comprehensive multidisciplinary online treatment program, based on an existing and effective face-to-face multidisciplinary pain program (the Reboot program).

Design & participants: A CONSORT-compliant randomized controlled trial was conducted, enrolling adults who had experienced pain for three months or longer.

Methods: Participants were randomly allocated to either an eight-lesson multidisciplinary pain management program, Reboot Online (N = 41), or to a usual care (UC) control group (N = 39). Clinical oversight was provided by a multidisciplinary team remotely, including physiotherapists and clinical psychologists. Participants were measured at baseline, post-treatment (week 16), and three-month follow-up (week 28).

Results: Intention-to-treat analyses revealed that Reboot Online was significantly more effective than UC at increasing pain self-efficacy (g = 0.69) at post-treatment, and these gains were maintained at follow-up. Similarly, Reboot Online was significantly more effective than UC on several secondary measures at post-treatment and follow-up, including movement-based fear avoidance and pain-related disability, but it did not significantly reduce pain interference or depression compared with UC. Clinician input was minimal, and adherence to Reboot Online was moderate, with 61% of participants (N = 25) completing all eight lessons.

Conclusions: Reboot Online presents a novel approach to multidisciplinary pain management and offers an accessible, efficacious alternative and viable treatment option for chronic pain management.

Keywords: Chronic Pain; Internet; Multidisciplinary Pain Management Program; Online Treatment; Telehealth.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Australia
  • Avoidance Learning
  • Catastrophization
  • Chronic Pain / physiopathology
  • Chronic Pain / psychology
  • Chronic Pain / therapy*
  • Cognitive Behavioral Therapy*
  • Exercise Therapy
  • Female
  • Humans
  • Internet-Based Intervention*
  • Male
  • Middle Aged
  • Pain Management / methods*
  • Pain Measurement
  • Patient Health Questionnaire
  • Physical Therapy Modalities*
  • Psychological Distress
  • Self Efficacy
  • Self-Management*
  • Young Adult