Trial reportThe Clinical journal of pain2015
Mediators and moderators of chronic pain outcomes in an online self-management program.
Trial report in The Clinical journal of pain, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Scoping review of equity considerations in digitally enabled patient education interventions for self-managing chronic musculoskeletal pain.Frontiers in public health · 2026Pooled it
- Pooled it
- Behavioral Modification as a Putative Mediator of Digital Therapeutic Response in Temporomandibular Disorders: Secondary Analysis of a Multicenter Sham-Controlled Randomized Trial.JMIR mHealth and uHealth · 2026Trial
- Lessons Learned from an Attempted Pragmatic Randomized Controlled Trial for Improvement of Chronic Pain-Associated Disability in Green Professions: Long-Term Effectiveness of a Guided Online-Based Acceptance and Commitment Therapy (PACT-A).International journal of environmental research and public health · 2022Trial
- Design considerations for a remote randomized multi-site clinical trial evaluating an e-health self-management program for chronic pain patients receiving opioid therapy.Contemporary clinical trials · 2021Trial
- Psychosocial Mechanisms of Cognitive-Behavioral-Based Physical Therapy Outcomes After Spine Surgery: Preliminary Findings From Mediation Analyses.Physical therapy · 2020Trial
- Brief Acceptance and Commitment Therapy for Fibromyalgia: Feasibility and Effectiveness of a Replicated Single-Case Design.Pain research & management · 2020Trial
- A randomized controlled trial of an online self-management program for adults with arthritis pain.Journal of behavioral medicine · 2015Trial
- Virtual and in-person chronic pain management outcomes: A retrospective observational study.Journal of military, veteran and family health · 2025Article
- A Comprehensive Literature Search of Digital Health Technology Use in Neurological Conditions: Review of Digital Tools to Promote Self-management and Support.Journal of medical Internet research · 2022Review
- Web-based cognitive behavior therapy for chronic pain patients with aberrant drug-related behavior: How did it work and for whom?Journal of behavioral medicine · 2021Article
- Neural Mechanisms of Acceptance and Commitment Therapy for Chronic Pain: A Network-Based fMRI Approach.Frontiers in human neuroscience · 2021Article
- An evaluation of a digital pain management programme: clinical effectiveness and cost savings.British journal of pain · 2020Article
- Psychological interventions for chronic non-specific low back pain: protocol of a systematic review with network meta-analysis.BMJ open · 2020Article
- Article
- Rationale and design of the Staying Positive with Arthritis (SPA) Study: A randomized controlled trial testing the impact of a positive psychology intervention on racial disparities in pain.Contemporary clinical trials · 2018Article
- Article
- Potential mediators of improvement in painful chemotherapy-induced peripheral neuropathy via a web-based cognitive behavioural intervention.Canadian oncology nursing journal = Revue canadienne de nursing oncologique · 2018Article
- Article
- Individual and dyadic coping in chronic pain patients.Journal of pain research · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesLittle is known about the moderators and mediators of change in online pain interventions based on cognitive-behavior therapy (CBT). We hypothesized that the effects of painACTION.com, an online pain self-management program, on pain-related outcomes would be mediated by changes in depression, anxiety, and stress, as well as the use of coping strategies. We also examined potential moderators of change.
methodsFirst, the efficacy of painACTION.com and moderators of the intervention effects were evaluated using a pooled sample from previous back, neuropathic, and arthritis pain studies. Next, we explored whether the intervention effect on the primary outcomes, pain severity, and patient global impression of change (PGIC), was mediated by coping strategies or emotional functioning.
resultsCompared with controls, experimental participants evidenced significant improvement in pain, emotional functioning, and coping strategies from baseline to follow-up. There were no clear moderators of intervention effects. Changes in emotional factors, particularly stress levels, mediated the relationship between the intervention and outcome (pain severity) over time. DISCUSSION: This study supports the effectiveness of online interventions when CBT and self-management targets pain levels, emotional factors, and wellness-focused coping. The importance of stress as a mediator of pain severity is discussed. The absence of moderators may indicate that the intervention is effective for a wide variety of patients with chronic pain.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.