Abstract
Objective: This study aimed to assess the feasibility of online Acceptance and Commitment Therapy for painful diabetic neuropathy in the United Kingdom and to determine if a larger randomised controlled trial testing treatment efficacy is justified.
Methods: Participants with painful diabetic neuropathy were recruited online and from hospital services. This was a single-arm study in which all participants received online Acceptance and Commitment Therapy. Participants completed questionnaires at baseline and 3-month post-treatment. Primary feasibility outcomes were recruitment, retention, and treatment completion rates. Secondary outcomes were pre- to post-treatment effects on pain outcomes and psychological flexibility.
Results: From 225 potentially eligible participants, 30 took part in this study. Regarding primary feasibility outcomes, the treatment completion and follow-up questionnaire completion rates were 40% and 100%, respectively. Generally, at baseline those who completed the treatment, compared to those who did not, had better daily functioning and higher psychological flexibility. With respect to secondary outcomes, results from the completers group showed clinically meaningful effects at post treatment for 100% of participants in pain intensity and pain distress, 66.7% in depressive symptoms, 58.3% in functional impairment, 41.7% in cognitive fusion, 66.7% in committed action, 58.3% in self-as-context, and 41.7% in pain acceptance.
Conclusions: This preliminary trial suggests feasibility of recruitment and follow-up questionnaire completion rates supporting planning for a larger randomised control trial. However, treatment completion rates did not achieve the pre-specified feasibility target. Changes to the treatment content and delivery may enhance feasibility of online Acceptance and Commitment Therapy for people with painful diabetic neuropathy on a larger scale.
Methods: Participants with painful diabetic neuropathy were recruited online and from hospital services. This was a single-arm study in which all participants received online Acceptance and Commitment Therapy. Participants completed questionnaires at baseline and 3-month post-treatment. Primary feasibility outcomes were recruitment, retention, and treatment completion rates. Secondary outcomes were pre- to post-treatment effects on pain outcomes and psychological flexibility.
Results: From 225 potentially eligible participants, 30 took part in this study. Regarding primary feasibility outcomes, the treatment completion and follow-up questionnaire completion rates were 40% and 100%, respectively. Generally, at baseline those who completed the treatment, compared to those who did not, had better daily functioning and higher psychological flexibility. With respect to secondary outcomes, results from the completers group showed clinically meaningful effects at post treatment for 100% of participants in pain intensity and pain distress, 66.7% in depressive symptoms, 58.3% in functional impairment, 41.7% in cognitive fusion, 66.7% in committed action, 58.3% in self-as-context, and 41.7% in pain acceptance.
Conclusions: This preliminary trial suggests feasibility of recruitment and follow-up questionnaire completion rates supporting planning for a larger randomised control trial. However, treatment completion rates did not achieve the pre-specified feasibility target. Changes to the treatment content and delivery may enhance feasibility of online Acceptance and Commitment Therapy for people with painful diabetic neuropathy on a larger scale.
| Original language | English |
|---|---|
| Pages (from-to) | 1-35 |
| Number of pages | 35 |
| Journal | Pain Medicine |
| Publication status | Published - 8 May 2020 |
