Médiateurs potentiels d’amélioration de la neuropathie périphérique chimio-induite douloureuse par une intervention cognitivocomportementale en ligne

Robert Knoerl, Debra L. Barton, Janean E. Holden, John C. Krauss, Beth LaVasseur, Ellen M.L. Smith

Abstract


Objet : Des données préliminaires ont révélé qu’une intervention autoguidée cognitivocomportementale de gestion de la douleur (PROSPECT) était efficace contre la neuropathie périphérique chronique douloureuse induite par chimiothérapie (NPCI), mais le mécanisme d’action demeure inconnu. L’objectif de cette analyse secondaire a consisté à déterminer si les changements par rapport à l’anxiété, à la dépression, aux troubles du sommeil ou à la fatigue diminuaient la douleur après l’utilisation de PROSPECT chez les patients atteints de NPCI. 

Méthodologie : En tout, 60 participants ont été sélectionnés au hasard pour recevoir soit l’intervention autoguidée cognitivocomportementale contre la douleur (accès pendant huit semaines), soit le traitement habituel. Un journal sur sept jours de suivi de la douleur due à la NPCI et le système PROMIS (Patient Reported Outcomes Measurement Information System) de mesure de l’anxiété, de la dépression, de la fatigue et des troubles du sommeil ont été utilisés avant et après l’étude (huit semaines). L’analyse de la médiation causale a été utilisée pour quantifier les médiateurs d’amélioration quant aux douleurs les plus intenses. 

Résultats : Aucun des médiateurs hypothétiques n’a eu un effet statistiquement important sur les douleurs les plus fortes (n = 38).

Implications : D’autres recherches sont nécessaires pour déterminer les médiateurs potentiels d’intensité de la douleur qui peuvent être ciblés par des stratégies cognitivocomportementales spécifiques afin d’améliorer la gravité de la douleur de la CIPN.

Mots clés : Douleur chronique, neuropathie périphérique chimio-induite, intervention cognitivocomportementale, maladie du système nerveux périphérique/chimio-induite


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