The Efficacy of the iCanCope Mobile Application for Neurofibromatosis Type 1 (NF1): A Three-Arm Randomized Controlled Trial.

Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic disorder that presents with severe chronic pain (CP) in adults. A limited number of NF1 research studies have evaluated behaviorally based interventions to address CP. The current study evaluated the efficacy of cognitive behavior therapy delivered via mobile application. The three-arm (treatment as usual [control], iCanCope only [iCC-NF], iCanCope + contingency management [iCC-NF + CM]) randomized clinical trial of 108 adults with NF1 and CP was completed during a 2-month intervention period. Significant improvements in pain interference (p = 0.005, d = 0.815) occurred in the iCC-NF + CM group when compared to the control group. Outcomes for pain self-efficacy (p = 0.009, d = 0.718), pain inflexibility (p = 0.026, d = 0.629), and chronic pain acceptance (p = 0.036, d = 0.653) significantly improved among the iCC-NF + CM group when compared to the control group. No significant differences were noted between iCC-NF + CM and iCC-NF. The current findings offer preliminary evidence of the added benefit of contingency management to mobile pain applications and provide an auxiliary treatment option for individuals with NF1. Trial Registration: ClinicalTrials.gov identifier: 2000029045.