Potential mediators of improvement in painful chemotherapy-induced peripheral neuropathy via a web-based cognitive behavioural intervention

• Main Authors: Robert Knoerl, Deborah L. Barton, Janean E. Holden, John C. Krauss, Beth LaVasseur, Ellen M.L. Smith
• Format: Article
• Language: English
• Published: Pappin Communications 2018-07-01
• Series: Canadian Oncology Nursing Journal
• Subjects: chronic pain; chemotherapy-induced peripheral neuropathy; cognitive behaviour therapy; peripheral nervous system disease/chemically induced
• Online Access: http://canadianoncologynursingjournal.com/index.php/conj/article/view/910

Purpose: Preliminary evidence suggests that a self-guided cognitive and behaviourally-based pain management intervention (PROSPECT) is effective for chronic painful chemotherapy-induced peripheral neuropathy (CIPN), but its mechanism of action is unknown. The purpose of this secondary analysis was to explore if changes in anxiety, depression, sleep-related impairment, or fatigue mediated improvements in worst pain following PROSPECT in individuals with chronic painful CIPN. Methods: Sixty participants were randomized to receive self-guided cognitive behavioural pain management (access for eight weeks) or treatment as usual. A seven-day worst CIPN pain diary and the PROMIS measures of anxiety, depression, fatigue, and sleep-related impairment were administered pre/posttest (eight-weeks). Causal mediation analysis was used to quantify mediators of worst pain improvement. Results: None of the hypothesized mediators had a statistically significant effect on worst pain (n=38). Implications: Further research is needed to identify potential mediators of pain intensity that can be targeted by specific cognitive behavioural strategies to improve painful CIPN severity.