Enhanced Pain Education for Chronic Pain

(PEPO Trial)

Overseen By Jean Tittley, MSc

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Laval University

Must not be taking: Corticosteroids

Disqualifiers: Rheumatoid, Inflammatory, Neurodegenerative, Fibromyalgia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

Duration: 10 weeks

86 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Enhanced Pain Education for Chronic Pain?

Research shows that pain self-management programs, which include education and peer support, are effective for managing chronic pain. Patients report learning useful information, feeling more in control, and experiencing less pain and distress after participating in these programs. ^{1 2 3 4 5}

Is enhanced pain education for chronic pain safe for humans?

The research does not provide specific safety data for enhanced pain education programs, but these programs generally focus on education and self-management, which are non-invasive and typically considered safe. ^{3 6 7 8 9}

How is the Pain self-management program different from other treatments for chronic pain?

The Pain self-management program is unique because it focuses on educating patients about pain and empowering them to manage it themselves through a structured, lay-led course. This approach emphasizes understanding pain biology and developing coping strategies, rather than relying solely on medication or medical interventions. ^{1 2 7 9 10}

What is the purpose of this trial?

The goal of this clinical trial is to compare two different modes of delivering a self-management program for chronic pain (independently vs. with additional support) on pain-related disability. Participants with chronic musculoskeletal pain will take part in a 10-week online pain self-management program. For the participants in the group with additional support, the intervention will also include two physiotherapist-led sessions and one group session with other participants. The hypothesis is that the results will support that both modes of delivery could be effective, but the self-management program with additional support will be more effective for reducing pain intensity and pain disability compared to the self-management program alone.

Research Team

Jean-Sébastien Roy, PhD

Principal Investigator

Laval University

Eligibility Criteria

This trial is for individuals who have been experiencing musculoskeletal pain for over three months. It's not suitable for those unable to commit to a 26-week study, or with conditions like rheumatoid, inflammatory or neurodegenerative diseases, fibromyalgia, complex regional pain syndrome, or recent corticosteroid injections.

Inclusion Criteria

I have had muscle or joint pain for over 3 months.

Exclusion Criteria

I have been diagnosed with a condition like rheumatoid arthritis, fibromyalgia, or similar.

I have had a corticosteroid injection in the last 3 months.

Unable to participate throughout the 26 weeks of the study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a 10-week online pain self-management program, with additional support for some participants including two physiotherapist-led sessions and one group session.

10 weeks

3 visits (in-person) for enhanced self-management group

Follow-up

Participants are monitored for changes in pain-related functional limitations and other secondary outcomes at 10 and 26 weeks.

16 weeks

2 evaluation sessions (virtual)

Treatment Details

Interventions

• Additional support for self-management program
• Pain self-management program

Trial Overview The PEPO Trial is testing a 10-week online self-management program for chronic pain. One group will follow the program independently while another will receive extra support including two sessions led by physiotherapists and one group session.

Participant Groups

Group I: Pain self-management with support from a physiotherapist Experimental Treatment 2 Interventions

Participants will complete an online pain self-management education program, and, during the treatment period, will take part in two sessions with a physiotherapist and one group session led by a peer living with chronic MSKP.

Group II: Pain self-management Active Control 1 Intervention

Participants will complete an online pain self-management education program by themselves as it is intended.

Who Is Running the Clinical Trial?

Laval University

Lead Sponsor

Trials

439

Recruited

178,000+

Quebec Pain Research Network

Collaborator

Trials

6

Recruited

10,700+

Findings from Research

The Chronic Pain Self-Management Programme (CPSMP) was found to be feasible and well-received by participants, with over 75% recommending it to others, indicating its potential for broader implementation.

Participants in the CPSMP experienced significant and stable improvements in pain, disability, and psychological factors like anxiety and depression over a 5-month follow-up, although the overall changes were modest.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A prospective evaluation of the Chronic Pain Self-Management Programme in a Danish population of chronic pain patients. Mehlsen, M., Heegaard, L., Frostholm, L.[2022]

The Cancer Pain Education for Patients and the Public (CPEPP) project aims to enhance pain management by providing essential education to patients and the public about cancer-related pain.

The CPEPP curriculum offers resources and support to ensure effective implementation of pain education, highlighting its importance in improving overall pain management strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cancer pain education for patients and the public. Ferrell, BR., Juarez, G.[2019]

A randomized controlled trial involving 215 veterans with chronic musculoskeletal pain tested a peer coach-delivered pain self-management program, but adherence to the program was low, with only 13% of patients attending the recommended number of meetings.

Both the peer support and control groups showed a decrease in total pain over 9 months, but there was no significant difference in pain reduction or other secondary outcomes between the two groups, suggesting that the peer support model may need to be revised for better effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer Support for Self-Management of Chronic Pain: the Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) Trial. Matthias, MS., Bair, MJ., Ofner, S., et al.[2021]

A study involving 219 veterans over 12 weeks showed high satisfaction with the 'Pain Education School' program, with participants reporting that the information was new, useful, and easy to understand.

Participants felt empowered to use the information learned in the program and were likely to recommend it to others, indicating its effectiveness in educating patients about managing chronic pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mixed-method approach to veteran satisfaction with pain education. Watson, EC., Cosio, D., Lin, EH.[2014]

A psychoeducational group program for 88 chronic pain patients led to significant improvements in mental health and pain management, including reduced depression and pain severity after 16 sessions.

At a 1-year follow-up, participants showed continued benefits such as increased return to work, lower healthcare visits, and reduced reliance on pain medication compared to a control group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychotherapy with the chronic pain patient using coping skills development: outcome study. Cole, JD.[2019]

A 12-week 'Pain Education School' for 102 veterans significantly improved their pain beliefs, readiness for self-management, and reduced depressive symptoms, indicating the program's effectiveness in managing chronic pain.

Veterans who participated in the program using an audience response system (ARS) showed greater increases in pain knowledge compared to those who did not use ARS, highlighting the benefits of active learning in pain education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Audience Response Systems to Enhance Chronic, Noncancer Pain Knowledge Acquisition Among Veterans. Simmons, EB., Cosio, D., Lin, EH.[2022]

In a study of 55 adults with chronic pain, those with higher education levels showed a greater improvement in pain biology knowledge after a 2-hour pain education session, with an average increase of nearly 2 points on the Neurophysiology of Pain Questionnaire (rNPQ).

Age was also a factor, as older participants (10 years older) had a smaller increase in rNPQ scores, suggesting that education level is a more significant predictor of knowledge gain from pain education than other clinical factors like pain severity or mental health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Which Patients With Chronic Pain Are More Likely to Improve Pain Biology Knowledge Following Education? Pate, JW., Veage, S., Lee, S., et al.[2019]

A pilot study involving 152 military health system beneficiaries demonstrated that an app-based pain education program was feasible and well-received, with 73% of participants finding the videos helpful.

The study suggests that providing tablet-based pain management education in various clinic settings, not just specialty pain clinics, can enhance patient understanding and discussions about pain management and opioid safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

App-Based Pain Management and Opioid Education Program for Patients in Clinic Waiting Rooms. Highland, KB., Giordano, NA., Kirk, K., et al.[2021]

A systematic review of nine studies on educational interventions for chronic pain found that education alone does not significantly reduce pain or disability in adults, with pooled data showing no improvement compared to usual care.

The only positive outcome was observed with pain neurophysiology education (PNE), which showed a decrease in disability and improved knowledge about pain, but the evidence is not strong enough to recommend PNE as a standalone treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis. Geneen, LJ., Martin, DJ., Adams, N., et al.[2022]

An 11-minute educational movie on chronic pain significantly increased pain knowledge among 95 adolescent students, with a notable effect size indicating strong effectiveness (ηp2 = 0.544).

Students who reported frequent pain (at least once a week) showed a greater increase in knowledge about managing chronic pain compared to those without frequent pain, suggesting targeted educational interventions may be particularly beneficial for this group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of a short educational movie on promoting chronic pain health literacy in school: A feasibility study. Wager, J., Stahlschmidt, L., Heuer, F., et al.[2019]

References

1. Ireland pubmed.ncbi.nlm.nih.gov

A prospective evaluation of the Chronic Pain Self-Management Programme in a Danish population of chronic pain patients. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Cancer pain education for patients and the public. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Peer Support for Self-Management of Chronic Pain: the Evaluation of a Peer Coach-Led Intervention to Improve Pain Symptoms (ECLIPSE) Trial. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Mixed-method approach to veteran satisfaction with pain education. [2014]

5. United States pubmed.ncbi.nlm.nih.gov

Psychotherapy with the chronic pain patient using coping skills development: outcome study. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Using Audience Response Systems to Enhance Chronic, Noncancer Pain Knowledge Acquisition Among Veterans. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Which Patients With Chronic Pain Are More Likely to Improve Pain Biology Knowledge Following Education? [2019]

8. United States pubmed.ncbi.nlm.nih.gov

App-Based Pain Management and Opioid Education Program for Patients in Clinic Waiting Rooms. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis. [2022]

10. England pubmed.ncbi.nlm.nih.gov

The impact of a short educational movie on promoting chronic pain health literacy in school: A feasibility study. [2019]