February 16, 2010 (San Antonio, Texas) — Patients with migraine headaches who used a Web site for support showed signs that they were coping better with their pain than those who did not use the Web site, researchers reported here at the American Academy of Pain Medicine 26th Annual Meeting.
After 6 months, those who used the painACTION Web site performed significantly better than others in assessments of sense of empowerment, use of relaxation strategies, use of social support, pain catastrophizing, depression, and stress.
A total of 185 patients were enrolled in the study; 92 were randomized to the painACTION group and 93 to the control group.
Patients were asked to complete self-assessments in areas such as coping and social interaction; they received immediate feedback with recommendations on ways they could improve in those areas.
"The aim of it is to get patients more actively involved in behavioral self-management and to deal with the psychological and social issues that are part and parcel of living with chronic pain," said lead investigator Jonas Bromberg, PsyD, senior research scientist at Inflexxion, in Newton, Massachusetts, which developed the painACTION. "What's different about this is that it's not just information. It's a real how-to approach."
"It really tailors the user experience," Dr. Bromberg told Medscape Neurology.
Using the site didn't actually alter pain levels, but scores in 6 categories measuring coping improved significantly after 1 month, 3 months, and 6 months of follow-up (P < .01 in almost all cases).
"People felt much more able to cope and manage, which is a really important thing," Dr. Bromberg said. "Even if you're still feeling pain, you kind of feel like, 'Oh, I can handle this'."
In addition to the recommendations, the Web site has links to articles on topics such as breaking the cycle of pain and depression, getting the most out of medical visits, and the difference between complaining and communicating.
Tips such as "Self-pity is a turnoff to healthy people" and "List what makes you happy" pepper the site.
There are also accounts by people who are experiencing chronic pain. Some are upbeat, like the one about a woman who turns to photography to cope. Some are not so upbeat, like the one about a woman feels she has been abandoned by nearly all of her friends.
Dr. Bromberg said the number of users doubled recently with the unveiling of an improved site, and said there are currently about 3000 registered users.
Timothy Deer, MD, president of the Center for Pain Relief in Charleston, West Virginia, and a cochair of the meeting, said the site is encouraging.
"When patients are educated properly about their condition, they do better," he said. "They know their options. They respond better to treatments because they understand the risks and benefits. So I encourage it. I think we ought to have our patients interact more in ways such as this. And this is a more modern way to do it."
The Web site was created by Inflexxion, and its development was supported with grants from the National Institute of Neurological Disorders and Stroke and the National Institute on Drug Abuse. Maintenance of the site is supported by Endo Pharmaceuticals and King Pharmaceuticals. Dr. Bromberg is an employee of Inflexxion. Dr. Deer has disclosed no relevant financial relationships.
American Academy of Pain Medicine (AAPM) 26th Annual Meeting: Abstract 163. Poster presented February 3-5, 2010.
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