TY  - JOUR
AU  - Edwards, Karlyn A
AU  - Dildine, Troy C
AU  - You, Dokyoung S
AU  - Herrick, Ashley M
AU  - Darnall, Beth D
AU  - Mackey, Sean C
AU  - Ziadni, Maisa S
PY  - 2025
DA  - 2025/3/11
TI  - Zoom-Delivered Empowered Relief for Chronic Pain: Observational Longitudinal Pilot Study Exploring Feasibility and Pain-Related Outcomes in Patients on Long-Term Opioids
JO  - JMIR Form Res
SP  - e68292
VL  - 9
KW  - Empowered Relief
KW  - single session
KW  - chronic pain
KW  - prescription opioids
KW  - telehealth
KW  - daily data
KW  - pain intensity
KW  - pain catastrophizing
AB  - Background: Patients with chronic pain on long-term opioid therapy often face barriers to accessing effective nonpharmacological treatments, including the burden of multiple sessions, lack of trained clinicians, and travel time. Empowered Relief (ER), a 2-hour, single-session pain relief skills class, can improve pain and quality of life among patients with chronic pain when delivered in person or virtually. Objective: This study examined the impact of Zoom-delivered ER among people with chronic pain on long-term opioid therapy. We assessed (1) the feasibility and acceptability of Zoom-delivered ER; (2) changes in pain and opioid use outcomes at 3 and 6 months after treatment; and (3) daily associations among pain, opioid dose, and the Pain Catastrophizing Scale (PCS) before and after treatment. Methods: During the early COVID-19 pandemic, we conducted an uncontrolled pilot study of a Zoom-delivered ER among 60 adults (n=45, 76% female participants; n=52, 88% White participants) experiencing chronic pain who were receiving daily prescribed opioids (≥10 morphine-equivalent daily dose). Participants completed assessments at enrollment, before class, after class, 3 months after treatment, and 6 months after treatment. Furthermore, participants completed 2 daily assessment periods (spanning 14 consecutive days) before and after the class. We used a multilevel modeling approach to examine (1) the raw changes in PCS, average pain intensity, pain interference, and self-reported opioid dose at 3 and 6 months after treatment and (2) daily-level changes in average pain intensity and opioid dose before and after the class. Results: Of the 60 participants enrolled, 41 (68%) attended the class and 24 (59% of the 41 class attendees) reported satisfaction with the Zoom-delivered class. PCS score was significantly reduced at 3 months (β=–3.49, P=.01; Cohen d=0.35) and 6 months after treatment (β=–3.61, P=.01; Cohen d=0.37), and pain intensity was significantly reduced at 3 months (β=–0.56, P=.01; Cohen d=0.39) compared to enrollment. There were no significant reductions in pain interference or opioid dose. Across daily assessments, higher daily pain catastrophizing was associated with worse daily pain (β=.42, P<.001) and higher self-reported opioid use (β=3.14, P<.001); daily pain intensity significantly reduced after the class (β=–.50, P<.001). People taking prescribed opioids as needed trended toward decreasing their daily opioid use after the class (β=–9.31, P=.02), although this result did not survive correction for multiplicity. Conclusions: Improvements to future Zoom-delivered ER iterations are needed to improve feasibility and acceptability among people with chronic pain and daily prescribed opioid use. Despite this, findings show a promising preliminary impact of the intervention on pain outcomes. A larger randomized controlled trial of Zoom-delivered ER among this patient population is currently under way. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2025/1/e68292
UR  - https://doi.org/10.2196/68292
DO  - 10.2196/68292
ID  - info:doi/10.2196/68292
ER  -