Internet-delivered Cognitive-behavioral Intervention for Pain in Pediatric Acute Recurrent and Chronic Pancreatitis: A Multicenter Randomized Controlled Trial

Objectives: – Abdominal pain is common and associated with high disease burden and health care costs in pediatric acute recurrent (ARP) and chronic pancreatitis (CP). Despite 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. Methods: – 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 (INternational Study Group of Pediatric Pancreatitis: In search for a cuRE) 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 pre-treatment, at 3 months, and 6 months post-treatment. Results: – 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 to WebED. There were no statistically significant between-group differences in pain or health outcomes. Conclusions: – 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.