Examining the Effectiveness of the Pain Course in a Regional Hospital Pain Clinic Setting

In this single group trial, all participants will receive access to an 8 week internet-delivered, self-guided education course, the Pain Course, which teaches participants how to manage chronic pain, anxiety, and low mood. All participants will have experienced chronic pain for longer than 6 months. The Pain Course comprises 5 online lessons, which provide information about evidence-based, cognitive behavioural strategies for managing pain, anxiety and depression. One lesson will be completed every 7 to 10 days. Each lesson will take about 20 minutes to read. Participants will also have access to summaries of each lesson, and will read anonymous stories about other people with chronic pain, depression, and anxiety, taking a further 20 minutes per week. All participants will receive automatic emails to promote adherence and engagement. Specifically, participants will receive an automatic email: a) from the study coordinator in the first week of the course to thank them for their participation; b) each time a new lesson becomes available; c) when they complete a lesson; d) if they have not started a given lesson within 7 days (i.e. a reminder email); e) in Week 4, to inform them that slight increases in symptoms at that point are not uncommon; f) in week 7 to encourage them to complete any remaining lessons by the end of week 8; g) in week 8 to remind them it is the last week and of the post-treatment questionnaires. As the receipt of some of these emails is contingent upon a participant’s activity (e.g. not completing a course within 7 days), the exact number of emails received will vary between participant. However, each will receive between 10 and 20 automatic emails over the duration of the course. Participants in this research trial are all those referred for clinical care to the North Queensland Persistent Pain Management Service. Participants will be asked to complete standardised questionnaire measures at 3 main time points: pre-treatment, post-treatment and 3-month follow up. Participants will also complete brief standardised questionnaire measures of depression weekly throughout the Course. To enable the researchers to monitor symptoms and safety throughout the Course, participants will also complete a single-item, question 9 from the PHQ-9, which measures suicidal ideation. This item will be measured at initial application, pre-treatment, mid-treatment, post-treatment and 3-month follow up, and weekly throughout the course. However, this item will not be used for reporting purposes, and has not been included in the list of Outcomes in Step 4. The strategy used to monitor adherence to the intervention will be online monitoring of lessons completed (i.e., completion is logged online once the participant clicks through all the slides of the lesson)