Lupus Erythematosus, Systemic Clinical Trial
Official title:
Internet-Based Pain Coping Skills Training (PainCOACH) for Patients With Lupus
This is a pilot study of an automated, internet-based pain coping skills training (PCST) program, PainCOACH.
Background and Significance: Systemic lupus erythematosus (SLE) is a chronic autoimmune
disease that impacts multiple organ systems. SLE results in a variety of challenging
symptoms, including flare-ups and periods of remission that are unpredictable, and it is a
complex disease to manage clinically. Because of these factors, SLE often has a major impact
on patients' quality of life. Notably, SLE is often associated with pain, fatigue, emotional
symptoms like anxiety and depression, and disability. Because of the relatively young average
age of SLE onset, many patients must navigate these challenges while maintaining work and /
or caring for young children.
Prior studies show that greater use of adaptive coping strategies and greater self-efficacy
for coping with SLE-related symptoms are associated with better physical and psychological
outcomes. Conversely, maladaptive coping behaviors, particularly pain catastrophizing (e.g.,
focusing on and exaggerating the threat of pain and negatively evaluating one's ability to
deal with pain), are associated with poorer SLE outcomes. Importantly, many studies in other
rheumatic conditions have shown that pain coping skills training (PCST) programs can improve
coping patterns, as well as physical and psychological health outcomes. However, there have
been no trials of PCST among individuals with SLE, who face a unique set of disease-related
challenges and are overall younger than patients with many other rheumatic conditions.
Delivery of PCST programs to patients with SLE could have a tremendous impact on outcomes and
quality of life, but this evidence base needs to be established, including adaptations of
current PCST programs that may be important specifically for patients with SLE. Therefore,
the objective of this project is to conduct a pilot study of an automated, internet-based
PCST program, PainCOACH, that has been shown to improve multiple key outcomes among patients
with osteoarthritis
Study Aims: This project has three specific aims: 1) Evaluate the feasibility and
acceptability of PainCOACH among patients with SLE. 2) Obtain a preliminary assessment of the
efficacy of PainCOACH (relative to a wait list control group) for improving pain interference
and other key outcomes among patients with SLE 3) Determine appropriate adaptations to
PainCOACH for patients with SLE.
Study Description: Investigators will conduct a randomized pilot study, with N=60 patients
age >= 18 years with physician diagnosis of systemic lupus erythematosus (SLE), equally
allocated to PainCOACH and a wait list control group that will be offered PainCOACH after
completion of the 9 week follow-up assessment. This design will allow a between-group
comparison as well as collection of acceptability data from the control group following their
completion of PainCOACH. Outcomes will be assessed at baseline and at about 9 week follow-up
as PainCOACH is designed for delivery over 8 weeks.
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