インターネット配信認知行動療法による小児急性再発性および慢性膵炎の疼痛管理：多施設共同無作為化比較試験

Abdominal pain is common and associated with high disease burden and health care costs in pediatric acute recurrent (ARP) and chronic pancreatitis (CP). Despite the effectiveness of psychological interventions in other abdominal pain populations, studies have not evaluated these interventions for pediatric pancreatitis pain. We evaluated the feasibility, acceptability, and preliminary efficacy of internet-delivered cognitive-behavioral therapy (CBT) for reducing pancreatitis-related abdominal pain and improving pain interference, anxiety, depression, activity limitations, and health-related quality of life.

We enrolled 90 adolescents (ages 10-19, 63% female) with ARP or CP and their parents into this randomized placebo-controlled multicenter trial from 15 INSPPIRE ( IN ternational S tudy Group of P ediatric P ancreatitis: I n search for a cu RE) centers or from the community. Participants were randomly assigned to internet-delivered CBT (WebMAP-CP; n=46) or internet-delivered pain education (WebED; n=44). Assessments were completed pretreatment, at 3 months, and 6 months posttreatment.

High feasibility of intervention delivery was demonstrated by strong treatment engagement (>6 of 8 modules completed) in both groups. Treatment acceptability was higher in the WebMAP-CP group compared with WebED. There were no statistically significant between-group differences in pain or health outcomes.

This is the first trial to evaluate the feasibility, acceptability, and preliminary efficacy of internet-delivered CBT for pediatric pancreatitis pain, demonstrating strong feasibility and treatment acceptability. Due to under-enrollment, the trial had reduced statistical power. Future research with a larger sample may build on these findings.