Transcending COVID-19 barriers to pain care in rural America: Pragmatic comparative effectiveness trial of evidence-based, on-demand, digital behavioral treatments for chronic pain

This
randomized comparative effectiveness trial compared two at-home, digital pain-management programs for rural adults
living with chronic pain during and after the COVID-19 pandemic. One
program (<b>painTRAINER</b>) delivered an 8-week behavioral pain-skills curriculum on a regular
screen (phone/computer). The other delivered an 8-week curriculum using <b>skills-based virtual
reality (VR) </b>headsets to create an immersive 3D environment. We enrolled 330 and analyzed 329 participants from from 3 large health networks (Cedars-Sinai Medical Center; the
University of Alabama in Birmingham and its affiliated ENRICH network; Ochsner
Health System) and
randomly assigned each person to one of the two programs. Over 8 weeks,
participants completed brief online surveys about pain (PROMIS-PI, pain
intensity) and distress (including COVID-related anxiety). The primary outcome of this study was to compare the difference in numeric pain score rating between the active VR and comparator 2D arm at week 8 of the intervention. A final Week 12 survey measured coping skill use 4 weeks after the completion of the assigned intervention. <br><br>Clinicaltrials.gov (NCT04933474): https://clinicaltrials.gov/study/NCT04933474.<br>