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Delivery Model Matters for Digital Interventions in Pain Self-Management: Mixed Methods Study
Lise Solberg Nes1,2,3, Elin Børøsund1,4, Elise Flakk Nordang1
1Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.
Journal of Medical Internet Research
|July 20, 2026
Summary
Digital pain self-management interventions are most effective with guided support. Blended care models improve outcomes for those needing it most, like individuals with lower education levels.
Area of Science:
- Digital health interventions
- Chronic pain management
- Evidence-based self-management
Background:
- Digital health interventions offer improved access to chronic pain support.
- Optimal delivery models for digital interventions remain unclear.
- Guided or blended care models show promise but are underutilized.
Purpose of the Study:
- Compare EPIO digital pain self-management intervention delivery: no follow-up vs. blended care vs. usual care.
- Evaluate intervention use and effects on chronic pain outcomes.
Main Methods:
- 73 participants received EPIO via digital download (no follow-up).
- Compared with 266 participants in a blended care trial and usual care controls.
- Assessed pain interference, severity, anxiety, depression, quality of life, catastrophizing, and acceptance over 12 months.
Main Results:
- EPIO without follow-up improved HRQoL, pain acceptance, and reduced catastrophizing compared to controls.
- Blended care showed greater program use and module completion.
- Higher education correlated with better outcomes in the no-follow-up group.
Conclusions:
- Digital intervention delivery models significantly impact effectiveness.
- Guided or blended care models are more beneficial.
- Blended care is recommended for high-need populations, such as those with lower education.
