Abstract
ObjectiveThis study aimed to assess the feasibility of online Acceptance and Commitment Therapy for painful diabetic neuropathy in the United Kingdom and to determine if a larger randomized controlled trial testing treatment efficacy is justified.MethodsParticipants with painful diabetic neuropathy were recruited online and from hospital services. This was a single-arm study in which all participants received online Acceptance and Commitment Therapy. Participants completed questionnaires at baseline and three months post-treatment. Primary feasibility outcomes were recruitment, retention, and treatment completion rates. Secondary outcomes were pre- to post-treatment effects on pain outcomes and psychological flexibility.ResultsOf 225 potentially eligible participants, 30 took part in this study. Regarding primary feasibility outcomes, the treatment completion and follow-up questionnaire completion rates were 40% and 100%, respectively. Generally, at baseline those who completed the treatment, compared with those who did not, had better daily functioning and higher psychological flexibility. With respect to secondary outcomes, results from the completers group showed clinically meaningful effects at post-treatment for 100% of participants for pain intensity and pain distress, 66.7% for depressive symptoms, 58.3% for functional impairment, 41.7% for cognitive fusion, 66.7% for committed action, 58.3% for self-as-context, and 41.7% for pain acceptance.ConclusionsThis preliminary trial suggests feasibility of recruitment and follow-up questionnaire completion rates, supporting planning for a larger randomized controlled trial. However, treatment completion rates did not achieve the prespecified feasibility target. Changes to the treatment content and delivery may enhance the feasibility of online Acceptance and Commitment Therapy for people with painful diabetic neuropathy on a larger scale.
Highlights
Painful diabetic neuropathy (PDN) is a complex pain condition associated with diabetes
The aim of this study was to assess the feasibility of conducting a larger randomized controlled trial (RCT) of online ACT for people with PDN
Partial feasibility was found for the research and treatment methods for evaluating online ACT for PDN in a larger RCT
Summary
Painful diabetic neuropathy (PDN) is a complex pain condition associated with diabetes. ACT has a growing evidence base for the treatment of chronic pain and appears to produce outcomes similar to traditional CBT [10,11]. Several studies have investigated online CBT and ACT for chronic pain, all yielding moderate to large improvements in pain and disability compared with waitlist controls or other psychological treatments [15,16,17,18,19,20]. The feasibility questions were whether online ACT would be acceptable to the PDN population, as reflected by adequate recruitment, follow-up questionnaire completion, and treatment completion rates. For each of these questions, a priori criteria were set against which to determine feasibility. In terms of secondary feasibility questions, effect sizes were calculated to determine whether participants who received ACT treatment would improve on pain outcomes and PF
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
