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Hilyard A, Kingsley J, Sommerfield D, Taylor S, Bear N, Gibson N. Feasibility of a Randomized Controlled Trial of Paediatric Interdisciplinary Pain Management Using Home-Based Telehealth. J Pain Res 2020; 13:897-908. [PMID: 32431538 PMCID: PMC7200248 DOI: 10.2147/jpr.s217022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 12/18/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Chronic pain is common in adolescents. Evidence-based guidelines recommend interdisciplinary treatment, but access is limited by geography. The development of hybrid programs utilizing both face-to-face and videoconference treatment may help overcome this. We developed a 7-week hybrid pediatric interdisciplinary pain program (Hybrid-PIPP) and wished to compare it to individual face-to-face sessions (Standard Care). Our objective was to test the feasibility of a protocol that used a matched pair un-blinded randomized controlled design to investigate the efficacy and cost-effectiveness of the Hybrid-PIPP compared to Standard Care. Patients and Methods Parent-adolescent dyads were recruited from tertiary pediatric clinics and matched by disability before randomization to minimize allocation bias. The adolescents (aged 11-17) had experienced primary pain for >3 months. Hybrid-PIPP involved 11 hrs of group therapy and 4 individual videoconference sessions. Standard care was provided by the same clinical team, using the same treatment model and similar intensity as the Hybrid-PIPP. The intention was to recruit participants for 3 Hybrid-PIPP groups with a comparison stream. Recruitment was ceased after 2 groups due to the high participant disability requiring more intensive intervention. Results Eighteen dyads were screened and 13 randomized (7 Hybrid-PIPP, 6 Standard Care, 2 unsuitable, 3 unallocated when the study was stopped). The study met a priori feasibility criteria for staff availability; recruitment rate; treatment completion; and data collection. Global satisfaction ratings were similar in both streams (SC median 7, range 5-9 and Hybrid-PIPP median 8.5, range 5-10). Challenges were identified in both streams. A future modified Hybrid-PIPP was considered acceptable if the intensity is increased to manage the high level of disability. Standard care was considered inefficient. No adverse events were reported. Conclusion The study determined that the protocol met a priori feasibility criteria, but to be practicable in a real world, health environment requires significant modifications. Registration ANZTR(ACTRN2614000489695).
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Affiliation(s)
- Anna Hilyard
- Complex Pain Service, Perth Children's Hospital, Perth, Western Australia, Australia.,Discipline of Psychology, College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Julia Kingsley
- Complex Pain Service, Perth Children's Hospital, Perth, Western Australia, Australia
| | - David Sommerfield
- Complex Pain Service, Perth Children's Hospital, Perth, Western Australia, Australia.,Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Australia.,Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Susan Taylor
- Complex Pain Service, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Natasha Bear
- Department of Child Research, Child Adolescent Health Service, Perth, Western Australia, Australia
| | - Noula Gibson
- Physiotherapy Department, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Formby P, Watson HJ, Hilyard A, Martin K, Egan SJ. Psychometric properties of the Compulsive Exercise Test in an adolescent eating disorder population. Eat Behav 2014; 15:555-7. [PMID: 25200383 DOI: 10.1016/j.eatbeh.2014.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 07/16/2014] [Accepted: 08/21/2014] [Indexed: 10/24/2022]
Abstract
The objective of this study was to evaluate the factor structure, validity, and reliability of the Compulsive Exercise Test (CET) in an adolescent clinical eating disorder population. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project, a prospective ongoing registry study comprising consecutive pediatric tertiary eating disorder referrals. Adolescents (N=104; 12-17years) with eating disorders completed the CET and other measures. Factor structure, convergent validity, and internal consistency were evaluated. Despite failing to identify a factor structure, the study provided clear evidence of the multidimensionality of the measure. The total score correlated significantly with measures of eating pathology, perfectionism, and frequency of exercise for shape and weight control (r=0.32-0.70, ps<0.05). More research into the multidimensional nature of compulsive exercise in clinical populations is needed. Further, research into compulsive exercise offers promise as an addition to existing cognitive behavioral models and treatments for eating disorders.
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Affiliation(s)
- Pam Formby
- School of Physiotherapy, University of Notre Dame, Perth, Australia
| | - Hunna J Watson
- Eating Disorders Program, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia; Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, United States; School of Psychology and Speech Pathology, Curtin University, Perth, Australia; School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
| | - Anna Hilyard
- Eating Disorders Program, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia
| | - Kate Martin
- Eating Disorders Program, Specialised Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Department of Health in Western Australia, Perth, Australia
| | - Sarah J Egan
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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