Internet-based treatment for vulvodynia (EMBLA) - Study protocol for a randomised controlled study.

ACT, Acceptance and commitment therapy Acceptance and commitment therapy BAI, Beck Anxiety Inventory CBT, Cognitive Behavioural therapy CPAQ, Chronic Pain Acceptance questionnaire EQ5-D, EuroQol-5-dimension questionnaire ESSI, ENRICHD Social Support Instrument FSDS-R, Female Sexual Distress Scale – Revised FSFI, Female Sexual Function Index Internet-based LOCF, last observation carried forward MADRS-S, Montgomery-Åsberg Depression Rating Scale Randomised controlled trial SWLS, Satisfaction with Life Scale Vulvodynia rDAS, Revised Dyadic Adjustment Scale

Journal

Internet interventions
ISSN: 2214-7829
Titre abrégé: Internet Interv
Pays: Netherlands
ID NLM: 101631612

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 25 06 2020
revised: 10 04 2021
accepted: 12 04 2021
entrez: 17 5 2021
pubmed: 18 5 2021
medline: 18 5 2021
Statut: epublish

Résumé

Vulvodynia is defined as vulvar pain for at least 3 months without a clear cause. To the best of our knowledge, there are no trials investigating the effects of internet treatment using CBT (Cognitive behavioural therapy) treatment with Acceptance and Commitment Therapy (ACT) components for women with vulvodynia. The aim of this study is to examine the effects of such a guided internet-based intervention on provoked vulvar pain during the waiting period before clinical treatment. We will randomise 52 patients to either guided internet-based intervention with CBT with (ACT) components or no intervention during the waiting period for treatment as usual. Online assessments are conducted at baseline, posttreatment, and at follow-up after 9 months. The primary outcome measure is provoked vulvar pain. Secondary outcomes are depression, anxiety, sexual function, and quality of life. Linear-mixed effect models will be used to assess the effect of the internet-based intervention on vulvar pain, pain acceptance, depression, anxiety, sexual function, and quality of life over time, by applying the intention-to-treat approach. Continuous data will be analysed with general linear models using intention-to-treat and also per protocol approaches to assess the effects of the intervention at different time points. Ordinal and binary data will be analysed with Mann Whitney's test, Fischer's exact test and multivariate logistic regression, respectively. As a randomised controlled trial with short- and long-term follow-up points, the EMBLA study intends to provide a novel and better understanding regarding the treatment of vulvodynia and the role of internet-based treatment as a complement to standard care for women suffering from vulvodynia. The effects of vulvodynia on pain, sexual function, quality of life, depression, and anxiety are investigated. The study's results are expected to be of value in the planning of clinical care in the medical area. High dropout rates and technical difficulties associated with using the platform are common in similar studies. NCT02809612.

Sections du résumé

BACKGROUND BACKGROUND
Vulvodynia is defined as vulvar pain for at least 3 months without a clear cause. To the best of our knowledge, there are no trials investigating the effects of internet treatment using CBT (Cognitive behavioural therapy) treatment with Acceptance and Commitment Therapy (ACT) components for women with vulvodynia. The aim of this study is to examine the effects of such a guided internet-based intervention on provoked vulvar pain during the waiting period before clinical treatment.
METHODS METHODS
We will randomise 52 patients to either guided internet-based intervention with CBT with (ACT) components or no intervention during the waiting period for treatment as usual. Online assessments are conducted at baseline, posttreatment, and at follow-up after 9 months. The primary outcome measure is provoked vulvar pain. Secondary outcomes are depression, anxiety, sexual function, and quality of life. Linear-mixed effect models will be used to assess the effect of the internet-based intervention on vulvar pain, pain acceptance, depression, anxiety, sexual function, and quality of life over time, by applying the intention-to-treat approach. Continuous data will be analysed with general linear models using intention-to-treat and also per protocol approaches to assess the effects of the intervention at different time points. Ordinal and binary data will be analysed with Mann Whitney's test, Fischer's exact test and multivariate logistic regression, respectively.
DISCUSSION CONCLUSIONS
As a randomised controlled trial with short- and long-term follow-up points, the EMBLA study intends to provide a novel and better understanding regarding the treatment of vulvodynia and the role of internet-based treatment as a complement to standard care for women suffering from vulvodynia. The effects of vulvodynia on pain, sexual function, quality of life, depression, and anxiety are investigated. The study's results are expected to be of value in the planning of clinical care in the medical area. High dropout rates and technical difficulties associated with using the platform are common in similar studies.
TRIAL REGISTRATION NUMBER BACKGROUND
NCT02809612.

Identifiants

pubmed: 33996511
doi: 10.1016/j.invent.2021.100396
pii: S2214-7829(21)00036-1
pmc: PMC8091887
doi:

Banques de données

ClinicalTrials.gov
['NCT02809612']

Types de publication

Journal Article

Langues

eng

Pagination

100396

Informations de copyright

© 2021 The Author(s).

Déclaration de conflit d'intérêts

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Références

Behav Res Ther. 2013 Jun;51(6):307-15
pubmed: 23548250
BMJ. 2010 Mar 23;340:c332
pubmed: 20332509
J Sex Marital Ther. 2005 Jan-Feb;31(1):1-20
pubmed: 15841702
Acta Obstet Gynecol Scand. 2010 Dec;89(12):1504-10
pubmed: 21080898
Qual Life Res. 2013 Sep;22(7):1717-27
pubmed: 23184421
West J Emerg Med. 2017 Oct;18(6):1075-1078
pubmed: 29085540
Hum Reprod. 2017 Jun 1;32(6):1258-1269
pubmed: 28383700
Clin J Pain. 2015 Jun;31(6):504-16
pubmed: 25380222
Am J Obstet Gynecol. 2012 Feb;206(2):170.e1-9
pubmed: 21963307
J Med Internet Res. 2010 Dec 19;12(5):e49
pubmed: 21169165
Arch Gen Psychiatry. 2004 Mar;61(3):310-7
pubmed: 14993119
J Psychosom Res. 2017 Feb;93:83-89
pubmed: 28107898
Pain. 2004 Jan;107(1-2):159-66
pubmed: 14715402
Int J Psychiatry Clin Pract. 2014 Oct;18(4):293-9
pubmed: 24994478
Aust Fam Physician. 2015 Jul;44(7):460-6
pubmed: 26590489
Pain. 2001 Apr;91(3):297-306
pubmed: 11275387
Pain. 2010 Jun;149(3):435-443
pubmed: 20188472
Drugs. 2019 Apr;79(5):483-493
pubmed: 30847806
J Low Genit Tract Dis. 2019 Apr;23(2):161-163
pubmed: 30768446
J Sex Marital Ther. 2006 Jul-Sep;32(4):289-304
pubmed: 16709550
Digit Health. 2019 Dec 16;5:2055207619896145
pubmed: 31897306
Dtsch Arztebl Int. 2017 Oct 13;114(41):681-688
pubmed: 29082858
Pain. 2009 Jan;141(1-2):31-40
pubmed: 19022580
Harv Rev Psychiatry. 2017 May/Jun;25(3):114-122
pubmed: 28475503
Clin Trials. 2016 Apr;13(2):161-8
pubmed: 26400875
J Sex Med. 2008 Feb;5(2):357-64
pubmed: 18042215
Eur J Pain. 2010 May;14(5):457-65
pubmed: 19819172
J Pers Assess. 1985 Feb;49(1):71-5
pubmed: 16367493
Am Psychol. 2014 Feb-Mar;69(2):178-87
pubmed: 24547803
Pain Pract. 2016 Feb;16(2):204-36
pubmed: 25581081
Cogn Behav Ther. 2003;32(3):100-9
pubmed: 16291542
Internet Interv. 2018 Apr 06;12:181-188
pubmed: 30135782
BMC Womens Health. 2015 Nov 25;15:108
pubmed: 26603697
J Consult Clin Psychol. 1988 Dec;56(6):893-7
pubmed: 3204199
Clin J Pain. 2017 Jun;33(6):552-568
pubmed: 27479642
Health Qual Life Outcomes. 2004 May 13;2:24
pubmed: 15142277
Curr Pain Headache Rep. 2016 Feb;20(2):12
pubmed: 26803836
BMC Fam Pract. 2011 Jul 04;12:66
pubmed: 21726443
World Psychiatry. 2019 Feb;18(1):20-28
pubmed: 30600624
J Sex Med. 2019 Feb;16(2):278-288
pubmed: 30655181
BMC Psychiatry. 2009 May 27;9:26
pubmed: 19473506
J Pain Res. 2018 Oct 02;11:2145-2159
pubmed: 30323649
Behav Res Ther. 2006 Jan;44(1):1-25
pubmed: 16300724
Eur J Pain. 2009 Aug;13(7):760-8
pubmed: 18926744
Obstet Gynecol. 2009 Apr;113(4):825-832
pubmed: 19305326
Eur J Pain. 2021 Jan;25(1):39-50
pubmed: 33001545
Nat Rev Dis Primers. 2020 Apr 30;6(1):36
pubmed: 32355269
Behav Res Ther. 2015 Nov;74:50-9
pubmed: 26409158
J Consult Clin Psychol. 2016 Mar;84(3):259-68
pubmed: 26727408
Cogn Behav Ther. 2018 Jan;47(1):1-18
pubmed: 29215315
J Am Med Inform Assoc. 2013 May 1;20(3):568-76
pubmed: 23065196
J Eur Acad Dermatol Venereol. 2017 Jun;31(6):925-941
pubmed: 28164373
J Sex Marital Ther. 2000 Apr-Jun;26(2):191-208
pubmed: 10782451
J Behav Med. 2015 Feb;38(1):66-80
pubmed: 24923259
Int J Reprod Biomed. 2016 Jan;14(1):57-62
pubmed: 27141550
Pharm Stat. 2010 Apr-Jun;9(2):87-99
pubmed: 19408241
J Consult Clin Psychol. 2008 Jun;76(3):397-407
pubmed: 18540733
Trials. 2013 Jun 09;14:166
pubmed: 23758961
Obstet Gynecol. 2016 Apr;127(4):745-751
pubmed: 27008217
Int J Behav Med. 2009;16(3):248-58
pubmed: 19288205
J Sex Med. 2011 Oct;8(10):2781-92
pubmed: 21771279
BMC Med Res Methodol. 2016 Aug 24;16(1):106
pubmed: 27557676
Int J Gynaecol Obstet. 2014 Dec;127(3):283-7
pubmed: 25092355
J Pain. 2014 Jan;15(1):101-13
pubmed: 24373572
J Sex Med. 2016 Mar;13(3):291-304
pubmed: 26944461
Front Psychol. 2018 Jan 11;8:2350
pubmed: 29375451
J Sex Med. 2016 Jan;13(1):88-94
pubmed: 26755091
J Low Genit Tract Dis. 2019 Apr;23(2):170-175
pubmed: 30688760
Int J Womens Health. 2014 May 02;6:437-49
pubmed: 24833921

Auteurs

Andrea Hess Hess Engström (AH)

Centre for Clinical Research, Västmanland County Hospital, Västerås, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Merit Kullinger (M)

Centre for Clinical Research, Västmanland County Hospital, Västerås, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Izabella Jawad (I)

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Susanne Hesselman (S)

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Center for clinical research, Uppsala University, Falun, Sweden.

Monica Buhrman (M)

Department of Psychology, Division of Clinical Psychology, Uppsala University, Uppsala, Sweden.

Ulf Högberg (U)

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Alkistis Skalkidou (A)

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Classifications MeSH