# Changes in cognition, coping, pain and emotions after 12-months access to the digital self-management program EPIO

## TL;DR

A digital self-management program called EPIO helped people with chronic pain improve their thinking, coping, and emotional well-being after 12 months of use.

## Contribution

The study provides novel insights into the long-term psychological and behavioral effects of a digital pain self-management program.

## Key findings

- Participants showed increased self-awareness and understanding of the connection between thoughts, feelings, and behavior.
- Users gained concrete coping strategies to manage pain and improve emotional regulation.
- The program's functionalities, such as breathing and thought-reflection exercises, contributed to positive changes.

## Abstract

Psychosocial pain self-management interventions can be of support for people living with chronic pain. Since psychosocial support is not always accessible, digital health interventions may increase outreach of these types of evidence-based interventions.

To explore participants' experiences from 12-month access to the digital pain self-management program EPIO, particularly in terms of any behavioral and/or psychological changes experienced.

Participants (N = 25) engaged in individual semi-structured interviews following 12-month access to the EPIO intervention. Qualitative thematic analyses were conducted seeking to identify any behavioral and/or psychological changes experienced through intervention use, and what contributed to these changes.

Participants were predominantly women (72%), median age 46 (range 26–70), with a range of self-reported pain conditions and the majority reporting pain duration >10 years (64%). Analyses identified three main themes and subsequent sub-themes: (1) Changes in Cognition; insight and self-awareness, acceptance and shifting focus, (2) Changes in Coping; pain, emotions, and activity pacing, and (3) Content and Functionality Specific Engagement; breathing and other mind-body exercises, thought-reflection exercises, and functionalities.

People with chronic pain experienced positive behavioral and/or psychological changes in terms of cognition and coping after 12 months access to the EPIO digital pain self-management program. The most prominent changes included increased understanding of the connection between own thoughts, feelings, and behavior, gaining concrete strategies to cope with everyday life living with pain, and utilizing these strategies to reduce pain and interference of pain, as well as to improve emotion regulation and psychological wellbeing.