Randomized clinical trial of computerized PAIN RelieveIt® for patients with sickle cell disease: PAIN ReportIt® and PAINUCope®

Objective: To compare effects of a tailored multimedia education program versus usual-care on barriers to pain management of adult patients with SCD. Methods: Pretest/posttest randomized controlled trial (RCT) of 228 outpatients with SCD randomized to the tablet-based PAINUCope intervention focused on barriers to pain management, pain, and analgesic adherence or selection of games (control). Outcomes were barriers to pain management, pain, and analgesic adherence. Results: The barriers to pain management and pain scores did not change significantly from pretest to posttest for either condition. Changes in analgesic adherence rates from pretest to posttest were statistically significant for the intervention group (p=.046) but not for the usual care group (p=.419). The group difference was not statistically significant. Conclusions: This first RCT of a tailored multimedia education intervention with adult patients with SCD did not significantly reduce the outcomes of interest compared to the control group. Findings provide insights for improving intervention delivery and reinforcement of patient behaviors. Practice implications: Study redesign is warranted with modifications that include theoretical and methodological approaches and patient-centered delivery of the intervention that take advantage of recent technology developments. (c) 2019 Elsevier B.V. All rights reserved.