Online Self-Management Treatment Program for Women Diagnosed with Interstitial Cystitis/Bladder Pain Syndrome

Abstract

Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic pelvic pain condition. An agreed-upon etiology for IC/BPS remains unspecified and medical treatment is often inadequate. Research has demonstrated the condition is associated with diminished quality of life (QoL), significant pain-related disability, greater pain catastrophizing, depressed mood, and decreased social support. Psychosocial treatments have been emphasized by health-care providers and researchers alike, but to date, no study has evaluated a psychosocial treatment program for this population. The literature suggests that online psychosocial treatments can effectively improve patient outcomes in various chronic pain samples. The present dissertation aimed to develop and evaluate the efficacy of an online psychosocial self-management treatment program for women with IC/BPS. Based on the literature on this population and evidence-based treatments, the program targeted psychosocial risk factors (pain catastrophizing, depression, social support, disability), with the aim of improving QoL. An expert review was conducted to gather feedback on program content. A pilot study assessed patient perceived usability of and satisfaction with the intervention, which was rated as satisfactory, useful, and valuable by patients. Improvements were made in accordance with patient feedback and the literature. Finally, a wait-list randomized controlled trial (RCT) evaluated the efficacy of the online self-management treatment program. It was hypothesized that treatment group participants would obtain improvements on the primary outcome measures of physical and mental QoL, as well as secondary outcome measures of depression, disability, pain catastrophizing, and social support, when compared with control group participants. Although these hypotheses were not supported, treatment group participants’ 3-month follow-up pain catastrophizing scores were statistically lower than baseline, and there was a clinically meaningful reduction in pain catastrophizing scores for treatment group participants, when compared with control group participants, at study end. The program was deemed highly satisfactory to patients who completed it. Theoretical and clinical implications are discussed. Study results led to considerations for future research. Important limitations of the present study include a large attrition rate and threats to internal validity in follow-up period analyses. Overall, an online self-management treatment program may be a potentially useful intervention for women with IC/BPS, but further research is needed.