57 Take Charge of Burn Pain: Development and Feasibility

Abstract

Burn related pain is a common experience post‐injury impacting physical, psychological and social recovery, and reducing long‐term function and community participation. While there have been extensive efforts to develop acute pain control strategies for use during the hospitalization phase of burn care, and self‐management pain management approaches have proven efficacy in other painful conditions, self‐management strategies for managing chronic pain due to burn injury have not been developed or tested. The goals of this project are to develop, and evaluate the efficacy of pain self-management, web‐based intervention, using an RCT design. This paper reports on the development of the program and provides data on the initial feasibility and acceptability. The the Take Charge of Burn Pain online self-management program (www.takechargeofburnpain.org) was developed in conjunction with the Phoenix Society, using a participatory action research model. This process resulted in a cognitive-behavioral based, 7 session, interactive program that utilizes the principles of self-management to provide knowledge, self-monitoring, pain coping skill development and practice. In the RCT, persons with burn related pain are randomized to standard care plus web-based education attention control) or standard care plus the TCB-Pain web-based self- management pain intervention. Patient reported outcomes are gathered via web-based questionnaires at baseline, 2 months and 5 month follow-up. Eligibility criteria are: 18 to 70 years of age, having experienced a burn injury requiring hospitalization at least 6 months prior to enrollment; 2) Reporting a pain severity score on the Brief Pain inventory of 4 (0‐10) or higher; 3) Reporting pain of at least 3 months duration; and 4) English speaking. The 108 participants are 56.5% female, 70% white, 14% Latino/Hispanic, 76% have more than high school education, and a mean age of 43. At program completion participants report high levels of satisfaction with the program (86% reported benefits equal or exceed effort put into the program). Of the 108 participants that have been enrolled 28 (26%) have not started the program and 12 (11%) inactive and 64 (60%) have completed. Participants report high levels of satisfaction with the program and perceive benefits at program completion. There are significant numbers of individuals who enroll in the program and do not complete. Additional research is needed to identify methods to enhance program completion and determine the long term impact on pain, pain interference, distress and quality of life. The Take Charge of Burn Pain program is designed to be part of a multi-modal pain program by providing an accessible, web‐based system, to develop evidenced‐based pain self‐management skills.