Development of the Pain Self-Management Program

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DESCRIPTION (provided by applicant): Pain accounts for almost 80% of all of the office visits to physicians each year (National Center for Health Statistics, 1986; Stucky, Gold, & Zhang, 2001; Winterowd, Beck, & Greuner, 2003) and is a major source of disability, accounting for upwards of 700 million lost work days and $100 billion in health care costs per year (Report of the Commission on Evaluation of Pain, 1986). In addition to physical morbidity and cost issues, psychological symptoms and lowered quality of life are frequent concomitants of chronic pain (Dworkin, Nagasako, Hetzel, & Farrar, 2001; McBeth, Macfarlane, & Silman, 2002). Precise prevalence figures for clinical pain disorders are not available, as different surveys have yielded estimates varying from 7% (Bowsher, Rigge, & Sopp, 1991) to 40% (Brattberg, Thorslund, & Wikman, 1989). Estimates vary by type of pain, ranging from 8% to 45% for low back pain (Girolamo, 1991) and from 2% to 50% for headaches (Stewart, Shechter, & Rasmussen, 1994) and differ even according to the definition of pain, ranging from 3% to 37% (e.g., Von Korff, Deworkin, & Le Resche, 1990). However, a conservative estimate would place the number of Americans with a lingering pain problem at approximately 80 million (National Research Council, 2001; U.S. Bureau of the Census, 1996). Despite the enormity of this public health problem, many individuals with chronic pain find it difficult to obtain treatment due to rising health care costs, increasing demand, and a reduction in the availability of multidisciplinary pain programs. Thus, there is a great need for alternative forms of care. The goal of the proposed project is the development of one such alternative, the Pain Self- Management Program (PSMP), a web-based psychoeducational self-help system for adults with chronic pain. The program is based on fundamental cognitive-behavioral principles that have been effectively applied in clinical practice, group interventions, and self-help books. The goal of Phase II is the final development and efficacy testing of the PSMP, which will consist of seven modules, including Program Overview, Understanding Chronic Pain, Profile of Chronic Pain Self-Assessment, Results, and Recommendations, and four Self-Management Modules. In addition, a number of interactive tools will be available for use across the Self-Management Modules. Specific Phase II tasks include final content development and review by several expert groups and software development. Following final beta testing and revision, the efficacy of the PSMP will be examined in a longitudinal study. Approximately 80 million people in the United States suffer from chronic pain. Due to the high costs of health care, increased demand for services, and dwindling access to multidisciplinary treatment programs, the need for alternative, cost-effective interventions is great. The purpose of the proposed project is the development of one such alternative, the Pain Self-Management Program (PSMP), a web-based psychoeducational self-help system for adults with chronic pain. The program is based on fundamental cognitive-behavioral principles that have been effectively applied in clinical practice, group interventions, and self-help books. The PSMP has the potential to provide scientifically sound information to large numbers of individuals with chronic pain at low cost.