A tailored pain self-management intervention for patients with cirrhosis is acceptable and improves pain control

Chronic pain is common and uniquely challenging to manage in people with cirrhosis. The purpose of this pilot study was to evaluate the feasibility and acceptability of a tailored pain self-management (PSM) intervention for people with cirrhosis and chronic pain.

This single-arm, single-site pilot study recruited patients with a diagnosis of cirrhosis and chronic pain to a virtual, health coach-led, modular PSM intervention. After 6 weekly one-on-one sessions, patients were invited to attend 6 weekly group sessions. Outcomes were measured at baseline, 6 weeks, 12 weeks (end of intervention), and 24 weeks (maintenance). The primary outcomes were acceptability, defined by a 4/5 rating on the Treatment Acceptability Questionnaire, and feasibility, defined as the ability to retain patients in 80% of the intervention sessions. Secondary outcomes of pain and function were measured using the Pain intensity, Enjoyment of life, and General activity (PEG) scales, and a rating of percent improvement with the intervention.

Among 21 participants who started the intervention, 16 (76%) attended ≥80% of sessions. Acceptability thresholds were met at all time points. On a scale of 0-100, where 30 is considered to be a meaningful change, participants rated their improvement in pain symptoms an average of 50 ± 25. The average PEG score decreased from 6.1 at baseline to 5.3 at 24 weeks. Participants reported increases in PSM behaviors, including cognitive and stress-reduction methods, physical activity, healthy sleep behaviors, and changes in diet.

This pilot identified a reduction in pain and an increase in PSM activities and demonstrated the acceptability of a health coach-led PSM intervention for adults with chronic pain and cirrhosis.