Impacts of the iCanCope Digital Pain Self-Management Program Among Adolescents and Young Adults With Chronic Pain: A Randomized Controlled Trial.

iCanCope™ (ICC) is a digital self-management program for 15-25 year olds with chronic pain. This study evaluated program satisfaction and efficacy through a two arm randomized controlled trial in Canadian tertiary care pain clinics. Participants were randomized to receive either ICC (app and website with symptom tracking and trending, pain education, goal setting, library, community forum) or an identically branded active control program with limited features. Outcomes were assessed at baseline, postprogram (2 months; T2), and follow-up (6 months; T3). Satisfaction was assessed using the Acceptability eScale and qualitatively with a subset of intervention participants. Linear mixed effects models characterized treatment effects on primary (pain interference) and secondary outcomes. Of 302 enrolled participants, 297 were analyzed (mean age = 17.1 ± 2.4, 83% female). Outcome completion rates were 89% at T2 and 71% at T3. Program acceptability was high in both the intervention (33.9 ± 7.0) and control group (32.7 ± 6.8). Most participants exhibited moderate to high engagement with daily checkins (intervention: 79%, active control: 80%). No significant treatment effects were found. However, improvements across time in pain interference at T2 (β = -0.58, p < .001) and T3 (β = -0.64, p = .0016) and improvements in knowledge about managing pain at T2 (β = -0.54, p < .0001) and T3 (β = -1.04, p < .0001) were found for both groups. Most (15/16) interviewees reported that ICC enhanced their confidence and/or ability to engage in pain self-management. Digitally mediated symptom tracking and trending and pain education is engaging and beneficial for 15-25 year olds with chronic pain. Use of an active-control may have diminished the ability to detect treatment-group effects. ICC has been translated to French-Canadian and publicly released as a free self-management tool. Trial Registration: ClinicalTrials.gov, NCT02601755.