A guided program compared with usual care
The researchers randomly assigned 133 adults with chronic pain to two groups. The first, comprising 66 participants, received the Pain Course: five online lessons over eight weeks, with clinical support. The other 67 participants continued their usual care while waiting for delayed access to the program.
The primary outcome was the impact of pain on activities, rather than pain intensity alone. The researchers also assessed depression, anxiety, average pain, fear of movement, pain acceptance and confidence in coping with pain.
Improvements after eight weeks
At the end of the program, improvements in functional interference, anxiety, depression and average pain were significantly greater in the treatment group. The standardized effect sizes reported for these measures ranged from 0.48 to 1.00. They describe differences between groups, not an individual's probability of relief.
The program completion rate was 80%. Average contact time with a clinician was about 81 minutes per participant. These findings therefore concern a guided intervention: they do not establish that an app used independently would deliver the same benefits.
The comparator imposes another limitation. The trial shows an advantage over usual care with delayed access, but does not compare this program with in-person CBT or another intervention providing comparable clinical attention.
At two years, only 44% of the treatment group responded
At three months, 55 participants in the treatment group were still being followed, or 83%. Benefits were maintained or improved. At two years, only 29 were still responding, or 44% of the original group.
Among these respondents, the effects were largely maintained. But their progress does not necessarily reflect that of people lost to follow-up. Moreover, the extended follow-up described in the abstract concerns only the treatment group: it does not demonstrate a lasting comparative advantage at two years.
Limitations to keep in mind
Only the Europe PMC abstract was consulted, not the full text. Substantial attrition and the lack of a long-term comparison limit interpretation at two years. The abstract does not detail adverse effects. Funding and conflicts of interest were not verified.
What we can take away
This trial supports the value of guided online CBT for reducing the short-term impact of chronic pain. It demonstrates neither the disappearance of pain nor a lasting benefit for all participants.
Sources and provenance
- An Internet-Based Cognitive-Behavioral Program, With Telephone Support, Improves Pain, Disability and Emotional Well-Being in Adults With Chronic Pain: Randomized Controlled Trial of the Pain Course With 2-Year Follow-Up.
Source date: 2026-11-01.
Randomized Controlled Trial, Journal Article · Résumé Europe PMC uniquement, texte intégral non consulté