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Feasibility and pilot testing of a personalized eHealth intervention for pain science education and self-management for breast cancer survivors with persistent pain: a mixed-method study

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Abstract

Purpose

Here, we describe the development and pilot study of a personalized eHealth intervention containing a pain science education program and self-management support strategies regarding pain and pain-related functioning in female survivors of breast cancer. First, we aimed to evaluate the eHealth intervention’s acceptability, comprehensibility, and satisfaction; second, we aimed to assess its preliminary efficacy.

Methods

A mixed-method study design was used. Breast cancer survivors with persistent pain were recruited. After 6 weeks of engagement with the eHealth intervention, acceptability, comprehensibility, and satisfaction were measured quantitatively with a self-constructed questionnaire and described qualitatively using focus groups. A joint display was used to present the meta-interferences between data. Efficacy was assessed via mixed effects models with repeated measures (outcomes assessed at baseline, 6 weeks, and 12 weeks).

Results

Twenty-nine women with persistent pain after breast cancer surgery participated. Overall, the eHealth program was well received and experienced as easy to use and helpful. The eHealth intervention seems useful as an adjunct to comprehensive cancer aftercare. Efficacy estimates suggested a significant improvement in pain-related functioning, physical functioning, and quality of life.

Conclusion

A personalized eHealth intervention appears valuable for persistent pain management after breast cancer surgery. A large controlled clinical trial to determine effectiveness, and a full process evaluation, seems warranted.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, ADG.

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Funding

The study was funded by Antwerp University, project number 41776.

Author information

Authors and Affiliations

  1. Department of Rehabilitation Sciences and Physiotherapy, MOVANT Research Group, University of Antwerp, Universiteitsplein 1, Antwerp, Belgium

    An De Groef, Sophie Van Dijck, Lore Dams, Vincent Haenen & Mira Meeus

  2. Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium

    An De Groef, Margaux Evenepoel & Vincent Haenen

  3. Pain in Motion International Research Group, Brussels, Belgium

    An De Groef, Sophie Van Dijck, Lore Dams, Vincent Haenen & Mira Meeus

  4. Innovation, Implementation & Clinical Translation (IIMPACT) in Health, University of South Australia, Kaurna Country, Adelaide, South Australia, Australia

    Louise Wiles, Mark Catley, Anna Vogelzang, Peter Hibbert & G. Lorimer Moseley

  5. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia

    Louise Wiles & Peter Hibbert

  6. Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia

    Louise Wiles & Peter Hibbert

  7. Department of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia

    Ian Olver

  8. Department of Cardiovascular Sciences, Section Anesthesiology and Algology, University of Leuven, Leuven, Belgium

    Bart Morlion

  9. Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK

    Lauren C. Heathcote

Authors
  1. An De Groef
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  2. Margaux Evenepoel
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  3. Sophie Van Dijck
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  4. Lore Dams
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  5. Vincent Haenen
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  6. Louise Wiles
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  7. Mark Catley
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  8. Anna Vogelzang
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  9. Ian Olver
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  12. G. Lorimer Moseley
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  13. Lauren C. Heathcote
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  14. Mira Meeus
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Contributions

ADG, LW, MC, IO, PH, BM, LGM, LH, and MM conceived and desgined the study and analyses; ME, SVD, VH collected the data; ME, SVD, VH, LD, ADG, and LH performed the analyses; ADG, ME, LH, MM, and LGM wrote the paper. All co-authors reviewed the manuscript.

Corresponding author

Correspondence to An De Groef.

Ethics declarations

Ethical approval

This study was approved by the Ethical Committee of the University Hospital of Antwerp and the University of Antwerp (ref. number: 001432). All participants gave written informed consent before data collection began. The trial was registered at ISRCTN registry (record 40472). The study is reported according to the STROBE guidelines.

Competing interests

GLM has received support from: Reality Health, ConnectHealth UK, Institutes of Health California, AIA Australia, Workers’ Compensation Boards and professional sporting organizations in Australia, Europe, and South and North America. Professional and scientific bodies have reimbursed him for travel costs related to presentation of research on pain and pain education at scientific conferences/symposia. He has received speaker fees for lectures on pain, pain education and rehabilitation. He receives royalties for books on pain and pain education.

ADG is a post-doctoral research fellow of the FWO-Flanders. GLM is supported by a Leadership Investigator grant from the National Health & Medical Research Council of Australia.

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An De Groef  and Margaux Evenepoel shared first authors. Lauren C. Heathcote and Mira Meeus shared senior authors.

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De Groef, A., Evenepoel, M., Van Dijck, S. et al. Feasibility and pilot testing of a personalized eHealth intervention for pain science education and self-management for breast cancer survivors with persistent pain: a mixed-method study. Support Care Cancer 31, 119 (2023). https://doi.org/10.1007/s00520-022-07557-7

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