Document Type
Article
Publication Date
12-24-2024
Abstract
Despite the burden of chronic pain in sickle cell disease (SCD), nonpharmacological approaches remain limited. This multisite, randomized trial compared digital cognitive behavioral therapy (CBT) with a digital pain/SCD education program ("Education") for managing pain and related symptoms. Participants were recruited virtually from seven SCD centers and community organizations in the United States. Adults (aged ≥18 years) with SCD-related chronic pain and/or daily opioid use were assigned to receive either CBT or Education for 12 weeks. Both groups used an app with interactive chatbot lessons and received personalized health coach support. The primary outcome was the change in pain interference at six months, with secondary outcomes including pain intensity, depression, anxiety, quality of life, and self-efficacy. Of 453 screened participants, 359 (79%) were randomized to CBT (n = 181) or Education (n = 178); 92% were Black African American, and 66.3% were female. At six months, 250 participants (70%) completed follow-up assessments, with 16 (4%) withdrawals. Engagement with the chatbot varied, with 76% connecting and 48% completing at least one lesson, but 80% of participants completed at least one health coach session. Both groups showed significant within-group improvements in pain interference (CBT: -2.13; Education: -2.66), but no significant difference was observed between them (mean difference, 0.54; P = .57). There were no between-group differences in pain intensity, depression, anxiety, or quality of life. High engagement with health coaching and variable engagement with digital components may explain the similar outcomes between interventions in this diverse, hard-to-reach population.
Recommended Citation
Jonassaint, Charles R.; Lalama, Christina M.; Carroll, C. Patrick; Badawy, Sherif M.; Hamm, Megan E.; Stinson, Jennifer N.; Lalloo, Chitra; Saraf, Santosh L.; Gordeuk, Victor R.; Cronin, Robert M.; Shah, Nirmish; Lanzkron, Sophie M.; Liles, Darla; O'Brien, Julia A.; Trimnell, Cassandra; Bailey, Lakiea; Lawrence, Raymona H.; Saint Jean, Leshana; DeBaun, Michael; De Castro, Laura M.; Palermo, Tonya M.; and Abebe, Kaleab Z., "Digital Cognitive Behavioral Therapy Vs Education for Pain in Adults with Sickle Cell Disease" (2024). Department of Medicine Faculty Papers. Paper 482.
https://jdc.jefferson.edu/medfp/482
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
39374587
Language
English
Comments
This article is the author's final published version in Blood Advances, Volume 8, Issue 24, 24 December 2024, Pages 6257-6266.
The published version is available at https://doi.org/10.1182/bloodadvances.2024013861. Copyright © 2024 by The American Society of Hematology.