INTERNET SUPPORT FOR SELF-MANAGING NEUROPATHIC PAIN -
DESCRIPTION (provided by applicant): Neuropathic pain (NP) is one of the most common pain conditions seen in clinical practice and is associated with significant physical and psychosocial morbidity. It is estimated that 40 per cent of people referred to pain clinics have NP. However, NP is often not diagnosed or misdiagnosed, so its incidence is likely to be higher. NP alters many aspects of a person's life, affecting physical, social, interpersonal, and emotional well-being. People with NP experience debilitating physical symptoms, and many lose their ability to function at pre-morbid levels in occupational, social, and interpersonal activities, along with significant impairment in mood stability, self-esteem, and experience isolation, helplessness, depression, stress, and anxiety. The financial burdens of NP are in the billions of dollars, and include increased healthcare costs, disability, and lost workdays. While it is widely recognized that a key part of effective pain treatment is engaging the person with pain in self-management, very few resources exist to support this, and those that exist are primarily clinic-based and not widely accessible. Many providers and people in pain remain unaware of the availability of effective behavioral interventions. As such, there is a critical need to develop widely accessible, behaviorally-focused, self-management interventions to meet the needs of people with NP. Interventions based on a cognitive-behavioral model offer excellent utility in meeting those needs, and helping people with NP become active in understanding and managing their pain. The Internet is an excellent vehicle to help people with NP learn pain self-management skills. Inflexxion currently offers a Web-based intervention called painACTION" to help people manage chronic pain due to cancer, migraine and back pain. We propose to develop and test a new component that addresses self-management of NP. The painACTION intervention will provide clinically reliable information about NP in order to motivate and support participant engagement in active pain self-management behaviors. The intervention will provide motivational messaging, tailored feedback, and personalized content recommendations to help people with NP manage and control their pain and pain symptoms, and improve their quality of life. The intervention will focus on teaching practical pain self-management skills, techniques, and strategies that help people play an active role in self-managing their pain. To facilitate the development of a clinically effective and engaging intervention, and differentiate painACTION from the competition, we will employ two innovative technical applications: (1) a custom recommendation engine to identify and deliver highly targeted content to individual users that address user's priorities and problems; and (2) a logic-based development platform to deploy branching logic for tailoring the flow of lesson content and assessment questions to user characteristics, and tailoring assessment feedback to user responses. Because the product will utilize these powerful Web technologies, be based on scientifically validated methods, be developed with input from key stakeholders, and will be subjected to a clinical field trial to demonstrate its effectiveness, we believe that pain ACTION will represent a significant advance in NP care. PUBLIC HEALTH RELEVANCE: Neuropathic pain (NP) is a common pain condition affecting millions of people and dramatically affects physical, social, and emotional well-being. Inflexxion offers a Web-based intervention to help people manage cancer, migraine and back pain, and is proposing to develop and test a new component support self-management of NP. Because we will use: two innovative technical applications (a custom recommendation engine and logic-based development platform), clinically validated intervention techniques, and test the effectiveness of the site, we believe the program offers a significant advance in NP care.
