PAIN+ CPN

Pester BD, Tankha H, Cano A, et al. Facing Pain Together: A Randomized Controlled Trial of the Effects of Facebook Support Groups on Adults With Chronic Pain. J Pain. 2022 Sep 9. pii: S1526-5900(22)00380-7. doi: 10.1016/j.jpain.2022.07.013. (Original study)
Abstract

Despite the popularity and affordances of social media groups for people with chronic conditions, there have been few controlled tests of the effects of these groups. This randomized controlled superiority trial examined the effects of Facebook groups on pain-related outcomes and tested whether a professional-led group leads to greater effects than a support group alone. We randomly assigned 119 adults with chronic pain to one of two Facebook group conditions: a standard condition (n = 60) in which participants were instructed to offer mutual support, or a professional-led condition (n = 59) in which the investigators disseminated empirically-supported, socially-oriented psychological interventions. Four groups were run (2 standard, 2 professional-led), each lasting 4 weeks and containing approximately 30 participants. Measures were administered at baseline, post-intervention, and 1-month follow-up. Across conditions, participants improved significantly in primary outcomes (pain severity and interference; medium-large effects) and a secondary outcome (depressive symptoms; small-medium effect), and they retained their outcomes 1 month after the groups ended. The 2 conditions did not differ on improvements. Overall, this study supports the use of social media groups as an additional tool to improve chronic pain-related outcomes. Our findings suggest that professional intervention may not have added value in these groups and that peer support alone may be driving improvements. Alternatively, the psychosocial intervention components used in the current study might have been ineffective, or more therapist direction may be warranted. Future research should examine when and how such guidance could enhance outcomes. PERSPECTIVE: Findings from this randomized trial support the use of both standard and professional-led Facebook groups as an accessible tool to enhance the lives of adults with chronic pain. This article provides direction for how to improve social media groups to optimize outcomes and satisfaction for more users.

Ratings
Discipline Area Score
Psychologist 6 / 7
Physician 5 / 7
Comments from MORE raters

Physician rater

A very applicable study to primary care and chronic pain. Given the significant lack of resources (or at least the availability of resources) for helping clinicians and patients manage chronic pain, Facebook groups seem to have positive effects for patients and are certainly more accessible. More study may be warranted, but the risk/benefit of the Facebook intervention should encourage clinicians to direct patients to these groups as a primary intervention.

Physician rater

The PROMs used in this study were not tested for content validity or for psychometric measurement properties. The results might, therefore, be due to a type-2-error. Also, since differential item functioning cannot be excluded, the measurements at the different assessments might be biased.

Psychologist rater

Considering the average improvement in all variables (maximum 1.25 reduction in a 0-10 scale of pain interference), it is questionable that either professional led or standard conditions might be considered as effective from a clinical point of view.

Psychologist rater

This is an essential contribution to the field. It opens the door to many more clinical questions.
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