CClinicalTrials.gg
Active, not recruitingNCT04462302IMPACTSUpdated Aug 11, 2026

An Internet-based Program to Help Cancer Survivors Manage Pain

An interventional study of Internet-based pain coping skills program in Cancer, sponsored by Wake Forest University Health Sciences. Active, not recruiting at 150 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-11.

Sponsored by Wake Forest University Health Sciences · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
456
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

To determine whether an Internet-based pain coping skills program plus enhanced usual care, compared to enhanced usual care alone, yields significant improvements in the co-primary outcomes of pain severity (as measured by the Brief Pain Inventory (BPI)) and pain interference (also measured by the BPI) from baseline to the post-intervention assessment for cancer survivors with persistent pain.

Read the detailed description

This is a parallel group randomized controlled, prospective study that examines the effect of an Internet-based pain coping skills program on pain severity and pain interference among adult cancer survivors experiencing persistent cancer-related pain. The study also explores the effects of an Internet-based pain coping skills program on opioid/analgesic medication use, health-related quality of life, pain management self-efficacy and various other factors relevant among populations with persistent pain (i.e., fatigue, sleep, emotional distress, positive affect, pain impact, perceived cognitive problems, and cognitive performance), as well as qualitative assessments of participants experiences with pain and the intervention. A total of 250 participants will be enrolled (125 per arm) and randomized into the internet program arm (plus enhanced usual care) or Enhanced Usual Care alone.

Each participant will be enrolled in the study for 9 months (from randomization at week 0 to the final follow-up assessment at week 34).

02

Conditions studied

  • Cancer

Keywords

  • Cancer pain
  • Survivor
  • Pain
  • Pain coping
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Must have a documented diagnosis of invasive cancer that has been treated with either single modality therapy or any combination of surgery, radiation, and chemotherapy/drug therapy (e.g. cytotoxic therapy, targeted therapy, immunotherapy, hormonal therapy, etc.). Patients with a cancer history of only superficial skin cancers or in situ malignancy are not eligible.

  • May be either off all treatment OR actively receiving anticancer therapy in an adjuvant setting, maintenance setting, or for active cancer.

    • Patients who currently undergoing anticancer therapy should not have any plans to change or adjust their treatment during the intervention period. This includes changing to another therapy or ending therapy entirely.
    • Patients who are currently receiving anticancer therapy at the screening process must have been on current therapy for at least four weeks. Alternatively, if they are planning to discontinue therapy before enrolling, they must have been off therapy for four weeks prior to enrollment.
    • A minimum of four weeks must have elapsed since the most recent MAJOR surgical intervention.
    • A minimum of two weeks must have elapsed since the most recent MINOR surgical procedure (e.g., port placement).
    • In addition, eligible patients must not have a planned surgical procedure or course of radiation therapy during the 3-month study intervention period (i.e., the three months leading up to primary outcome evaluation-timepoint.
  • Patients who are no longer receiving anticancer therapy must be less than/equal to 5 years since the completion of their anticancer therapy (e.g., time since the last day of chemotherapy administration, time since last day of radiotherapy, etc.).
  • Must have pain indicated by a score of ≥ 4 on PROMIS Pain Intensity (1a) scale, using the Pain Eligibility Interview.
  • Must have a score of "Most Days" or higher on the Graded Chronic Pain Scale Revised (Abbreviated) using the Pain Eligibility Interview.
  • Patients do not have to be on analgesic medications of any kind in order to participate. If they are taking analgesics, they must be on a stable analgesic regimen (i.e., no changes to the prescribed analgesic regimen) over a period of at least 14 days prior to enrollment. Eligible patients should not have planned upward dose titration of their analgesics during the 3-month study intervention period (i.e., the three months leading up to primary outcome evaluation timepoint. Patients may elect to decrease their analgesic use during the study as per discussions with their provider. Unexpected dose adjustments including dose escalations as a result of unforeseen clinical need is allowed in all patients at all times during the study. Cannabis prescribed for medicinal purposes would qualify as an analgesic in this context.
  • Must have pain of new onset or significantly exacerbated since the time of cancer diagnosis or initiation of cancer treatment
  • Must be expected to be able to complete all study activities including the 22- and 34-week follow-up assessments according to the treating/referring clinician (e.g., treating clinician feels the patient is unlikely to develop progressive disease requiring additional active cancer therapy through the 6-month follow-up period).
  • ECOG performance status of 0, 1, or 2.
  • Age ≥18 years at the time of study entry
  • Must be able to speak, read and understand English.

Exclusion criteria

Exclusion Criteria:

  • Has a disability that precludes completion of study activities (e.g., severe vision or hearing impairment, diagnosis of dementia or clinical evidence of severe cognitive impairment, diagnosis or clinical evidence of severe psychiatric disorder, or diagnosed drug or alcohol abuse disorder), as per patient report or documented in the medical record.
  • Reports only preexisting pain conditions unrelated to cancer or cancer treatment (e.g., migraine or tension headache, arthritis, back disorders, bursitis/tendonitis, injuries, fibromyalgia).
  • Has a known or suspected diagnosable substance use disorder or opioid overuse disorder (according to DSM-5 criteria), or is actively receiving treatment for a substance use disorder, as per patient report or documented in the medical record.
  • Currently being prescribed buprenorphine or suboxone.
  • Patients enrolled on hospice care or end-of-life palliative care are not eligible for enrollment. Patients whose local care network provides an opportunity for palliative (symptom management) or supportive care concurrent with active treatment following diagnosis (i.e. not solely as a palliative or end-of-life measure) are considered eligible for this study.
  • Does not have reliable access to Internet or sufficient personal data plan, and is not willing to participate in the Tablet Lending Program provided for this study.
  • Does not have a working email address.
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
456 participants (estimated)

Study arms

  • Experimental
    Internet-based program + Pain Education

    If you are in this group, in additional to your usual care, you will be provided access to the 8-session Internet-based pain program plus pain education. You will need to complete your sessions within 10 weeks of being provided your log-in code. You will be allowed to revisit sessions that you have completed during this 10 weeks. After completion of the study, you will still be provided access to the 8-session Internet-based pain program.

    Behavioral: Internet-based pain coping skills program

  • No intervention
    Pain Education Only

    If you are in this group, in addition to your usual care, you will be provided pain education at your initial clinic visit. After you have completed the 6-month follow up assessment, you will be provided a secure log-in code and invited to complete the 8 sessions of this Internet-based pain program on your own.

Interventions

  • BehavioralInternet-based pain coping skills program

    The purpose of this study is to determine if an 8-session Internet-based pain management program can help you better manage your cancer-related pain.

05

What researchers measure

Primary outcomes

  1. Pain Severity

    The Pain Severity via Brief Pain Inventory (BPI) subscale score is the mean of 4 items measuring current pain, pain on average, and pain at its worst and least in the past 7 days on a scale from 0 (no pain) to 10 (pain as bad as you can imagine).

    Time frame: Change from Baseline to 10 week

  2. Pain Interference

    The Pain Interference via Brief Pain Inventory (BPI) subscale score is the mean rating of 7 items measuring impact of pain on walking, work, mood, enjoyment of life, relations with others, sleep, general activity on a scale from 0 (does not interfere) to 10 (completely interferes).

    Time frame: Change from Baseline to 10 week

Secondary outcomes

  1. Pain Severity

    The Pain Severity via Brief Pain Inventory (BPI) subscale score is the mean of 4 items measuring current pain, pain on average, and pain at its worst and least in the past 7 days on a scale from 0 (no pain) to 10 (pain as bad as you can imagine).

    Time frame: 22 and 34 weeks

  2. Pain Interference

    The Pain Interference via Brief Pain Inventory (BPI) subscale score is the mean rating of 7 items measuring impact of pain on walking, work, mood, enjoyment of life, relations with others, sleep, general activity on a scale from 0 (does not interfere) to 10 (completely interferes).

    Time frame: 22 and 34 weeks

  3. Opioid/analgesic medication use

    A participant recall during clinic visits of typical daily medication use. This will be converted to morphine milligram equivalents (MME).

    Time frame: Baseline and 10 week

  4. Opioid/analgesic medication use

    7-day medication diaries to capture participants' use of all medications each day during a 7-day period. Self-reports will be converted to morphine milligram equivalents (MME).

    Time frame: Baseline, 10, 22, and 24 week

  5. Health-Related Quality of Life

    Health-Related Quality of Life will be assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (Short Form-6b). The six items are summed to give a score from 6 to 30, with higher scores representing better physical function.

    Time frame: Baseline, 10, 22, and 24 week

  6. Pain Management Self-Efficacy

    Pain Management Self-Efficacy will be assessed with the Chronic Pain Self-Efficacy Scale. The self-efficacy for pain management subscale (PSE) consists of five items summed to give a score from 50-500, the self-efficacy for physical function subscale (FSE) consists of nine items summed to give a score from 90-900, and the self-efficacy for coping with symptoms subscale (CSE) consists of eight items summed to give a score from 80-800. For all subscales, higher scores represent greater self-efficacy.

    Time frame: Baseline, 10, 22, and 24 week

06

Study locations

150 sites
  • Mercy Hospital Fort Smith
    Fort Smith, Arkansas 72903, United States
  • Kaiser Permanente-Deer Valley Medical Center
    Antioch, California 94531, United States
  • Kaiser Permanente Dublin
    Dublin, California 94568, United States
  • Kaiser Permanente-Fremont
    Fremont, California 94538, United States
  • Kaiser Permanente-Fresno
    Fresno, California 93720, United States
  • Kaiser Permanente-Modesto
    Modesto, California 95356, United States
  • Kaiser Permanente-Oakland
    Oakland, California 94611, United States
  • Kaiser Permanente- Marshall Medical Offices
    Redwood City, California 94063, United States
  • Kaiser Permanente-Richmond
    Richmond, California 94801, United States
  • Kaiser Permanente-Roseville
    Roseville, California 95661, United States
  • Kaiser Permanente Downtown Commons
    Sacramento, California 95814, United States
  • Kaiser Permanente-South Sacramento
    Sacramento, California 95823, United States
  • Kaiser Permanente-San Francisco
    San Francisco, California 94115, United States
  • Kaiser Permanente-Santa Teresa-San Jose
    San Jose, California 95119, United States
  • Kaiser Permanente San Leandro
    San Leandro, California 94577, United States
  • Kaiser San Rafael-Gallinas
    San Rafael, California 94903, United States
  • Kaiser Permanente Medical Center - Santa Clara
    Santa Clara, California 95051, United States
  • Kaiser Permanente-Santa Rosa
    Santa Rosa, California 95403, United States
  • Kaiser Permanente-South San Francisco
    South San Francisco, California 94080, United States
  • Kaiser Permanente-Stockton
    Stockton, California 95210, United States
  • Kaiser Permanente Medical Center-Vacaville
    Vacaville, California 95688, United States
  • Kaiser Permanente-Vallejo
    Vallejo, California 94589, United States
  • Kaiser Permanente-Franklin
    Denver, Colorado 80205, United States
  • Kaiser Permanente-Rock Creek
    Lafayette, Colorado 80026, United States
  • Kaiser Permanente-Lone Tree
    Lone Tree, Colorado 80124, United States
  • John B. Amos Cancer Center
    Columbus, Georgia 31904, United States
  • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
    Savannah, Georgia 31405, United States
  • Hawaii Cancer Care Inc - Waterfront Plaza
    Honolulu, Hawaii 96813, United States
  • Queen's Cancer Cenrer - POB I
    Honolulu, Hawaii 96813, United States
  • Queen's Medical Center
    Honolulu, Hawaii 96813, United States
  • Straub Clinic and Hospital
    Honolulu, Hawaii 96813, United States
  • University of Hawaii Cancer Center
    Honolulu, Hawaii 96813, United States
  • Queen's Cancer Center - Kuakini
    Honolulu, Hawaii 96817, United States
  • The Cancer Center of Hawaii-Liliha
    Honolulu, Hawaii 96817, United States
  • Kaiser Permanente Moanalua Medical Center
    Honolulu, Hawaii 96819, United States
  • Kapiolani Medical Center for Women and Children
    Honolulu, Hawaii 96826, United States
  • Tripler Army Medical Center
    Honolulu, Hawaii 96859, United States
  • Hawaii Cancer Care - Savio
    ‘Aiea, Hawaii 96701, United States
  • Hawaii Cancer Care - Westridge
    ‘Aiea, Hawaii 96701, United States
  • Pali Momi Medical Center
    ‘Aiea, Hawaii 96701, United States
  • The Cancer Center of Hawaii-Pali Momi
    ‘Aiea, Hawaii 96701, United States
  • The Queen's Medical Center - West Oahu
    ‘Ewa Beach, Hawaii 96706, United States
  • Carle BroMenn Outpatient Center
    Bloomington, Illinois 61704, United States
  • Illinois CancerCare-Bloomington
    Bloomington, Illinois 61704, United States
  • Illinois CancerCare-Canton
    Canton, Illinois 61520, United States
  • Northwestern University
    Chicago, Illinois 60611, United States
  • Carle at The Riverfront
    Danville, Illinois 61832, United States
  • Carle on Vermilion
    Danville, Illinois 61832, United States
  • Cancer Care Specialists of Illinois - Decatur
    Decatur, Illinois 62526, United States
  • Decatur Memorial Hospital
    Decatur, Illinois 62526, United States
  • Illinois CancerCare-Galesburg
    Galesburg, Illinois 61401, United States
  • Carle Physician Group-Mattoon/Charleston
    Mattoon, Illinois 61938, United States
  • Carle BroMenn Medical Center
    Normal, Illinois 61761, United States
  • Carle Cancer Institute Normal
    Normal, Illinois 61761, United States
  • Illinois CancerCare-Ottawa Clinic
    Ottawa, Illinois 61350, United States
  • Illinois CancerCare-Pekin
    Pekin, Illinois 61554, United States
  • Illinois CancerCare-Peoria
    Peoria, Illinois 61615, United States
  • Illinois CancerCare-Peru
    Peru, Illinois 61354, United States
  • Carle Cancer Center
    Urbana, Illinois 61801, United States
  • Illinois CancerCare - Washington
    Washington, Illinois 61571, United States
  • UI Health Care Mission Cancer and Blood - Ankeny Clinic
    Ankeny, Iowa 50023, United States
  • Physicians' Clinic of Iowa PC
    Cedar Rapids, Iowa 52402, United States
  • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
    Clive, Iowa 50325, United States
  • Medical Oncology and Hematology Associates-Des Moines
    Des Moines, Iowa 50309, United States
  • Broadlawns Medical Center
    Des Moines, Iowa 50314, United States
  • Mercy Medical Center - Des Moines
    Des Moines, Iowa 50314, United States
  • UI Health Care Mission Cancer and Blood - Laurel Clinic
    Des Moines, Iowa 50314, United States
  • UI Health Care Mission Cancer and Blood - Waukee Clinic
    Waukee, Iowa 50263, United States
  • Flaget Memorial Hospital
    Bardstown, Kentucky 40004, United States
  • Saint Joseph Radiation Oncology Resource Center
    Lexington, Kentucky 40504, United States
  • Saint Joseph Hospital East
    Lexington, Kentucky 40509, United States
  • Saint Joseph London
    London, Kentucky 40741, United States
  • Ochsner Baptist Medical Center
    New Orleans, Louisiana 70115, United States
  • Ochsner Medical Center Jefferson
    New Orleans, Louisiana 70121, United States
  • CHRISTUS Highland Medical Center
    Shreveport, Louisiana 71105, United States
  • MaineHealth Cancer Care Center of York County
    Sanford, Maine 04073, United States
  • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
    Ann Arbor, Michigan 48106, United States
  • Trinity Health Medical Center - Brighton
    Brighton, Michigan 48114, United States
  • Trinity Health Medical Center - Canton
    Canton, Michigan 48118, United States
  • Chelsea Hospital
    Chelsea, Michigan 48118, United States
  • Genesee Cancer and Blood Disease Treatment Center
    Flint, Michigan 48503, United States
  • Genesee Hematology Oncology PC
    Flint, Michigan 48503, United States
  • Genesys Hurley Cancer Institute
    Flint, Michigan 48503, United States
  • Marshfield Medical Center Dickinson
    Iron Mountain, Michigan 49801, United States
  • Trinity Health Saint Mary Mercy Livonia Hospital
    Livonia, Michigan 48154, United States
  • Trinity Health Saint Joseph Mercy Oakland Hospital
    Pontiac, Michigan 48341, United States
  • Mercy Hospital
    Coon Rapids, Minnesota 55433, United States
  • Fairview Southdale Hospital
    Edina, Minnesota 55435, United States
  • Saint John's Hospital - Healtheast
    Maplewood, Minnesota 55109, United States
  • Abbott-Northwestern Hospital
    Minneapolis, Minnesota 55407, United States
  • North Memorial Medical Health Center
    Robbinsdale, Minnesota 55422, United States
  • Park Nicollet Clinic - Saint Louis Park
    Saint Louis Park, Minnesota 55416, United States
  • Regions Hospital
    Saint Paul, Minnesota 55101, United States
  • United Hospital
    Saint Paul, Minnesota 55102, United States
  • Lakeview Hospital
    Stillwater, Minnesota 55082, United States
  • Rice Memorial Hospital
    Willmar, Minnesota 56201, United States
  • Minnesota Oncology Hematology PA-Woodbury
    Woodbury, Minnesota 55125, United States
  • Central Care Cancer Center - Bolivar
    Bolivar, Missouri 65613, United States
  • Heartland Regional Medical Center
    Saint Joseph, Missouri 64506, United States
  • CentraState Medical Center
    Freehold, New Jersey 07728, United States

Showing the first 100 of 150 sites across 2 countries.

07

References and documents

Individual participant data

Plan to share: Yes — Wake Forest NCORP Research Base is committed to following the NIH Statement on Sharing Research Data (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-032.html). As of July 2018, the WF NCORP RB signed an agreement with NCI to contribute de-identified data and data dictionaries from clinical trials conducted through our RB to the NCI NCTN/NCORP data archive within 6 months of primary and non-primary publications of phase II/III and phase III trials to https://nctn-data-archive.nci.nih.gov/. This will become the primary means for sharing raw data, and we will adhere to the guidelines spelled out in the NCTN/NCORP Data Archive Usage Guide. De-identified data from studies not covered by the agreement (e.g., phase II and observational studies) will be made available upon request. All data files will be de-identified. De-identification procedures will meet the HIPAA criteria as detailed in the Code of Federal Regulations, Part 45, Section 164.514.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04462302
Lead sponsor
Wake Forest University Health Sciences
Collaborators
National Cancer Institute (NCI), National Institute of Neurological Disorders and Stroke (NINDS)
Responsible party
Sponsor
First posted
Jul 8, 2020
Start date
May 13, 2021
Primary completion
May 31, 2027 (estimated)
Completion
May 31, 2028 (estimated)
Last update
Aug 11, 2026

Study contacts

Glenn Lesser, MD
study chair · Wake Forest University Health Sciences

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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