The endometriosis pain course: Exploring predictors of clinical response to an internet-delivered psychological pain management program for endometriosis

Chandra SS, Shianika S Chandra, Amelia J. Scott, Madelyne A. Bisby, Nickolai Titov, Blake F. Dear
The journal of pain · 2026 · vol. 46 , pp. 106350 · doi:10.1016/j.jpain.2026.106350 · PMID:42264427 · W7163879829
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This study investigated factors predicting clinical improvement in endometriosis-associated pain following an internet-delivered psychological pain management program.

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Abstract

Emerging research indicates the potential of psychological pain management programs to address disability and distress associated with endometriosis-related pain. Understanding the characteristics of patients likely to benefit from such programs is essential for guiding their optimal use. The current study used data from a previous randomized controlled trial (N = 193) of an internet-delivered psychological pain management program for endometriosis, the Endometriosis Pain Course. This study examined the relationships between commonly collected demographic, clinical, baseline severity, and psychological variables with clinical response (defined as ≥30% and ≥50% improvement in each outcome), treatment completion, and treatment satisfaction. Clinical response to the outcomes of pain-related disability, depression, anxiety, and average pain intensity was examined at post-treatment and 3-month follow-up. Multivariate binary logistic regression analyses assessed the unique contribution of each predictor variable in the likelihood of clinical response, treatment completion, and treatment satisfaction. Overall, few predictors were significant across ≥1 clinical outcome, none were significant across all four outcomes, and no predictors of treatment completion or satisfaction emerged. However, higher baseline severity was uniquely associated with greater odds of clinical response on all four outcomes at each timepoint. These findings suggest that this treatment approach may be suitable for a broad range of patients with endometriosis, including those with more severe symptoms. PERSPECTIVE: This study explored predictors of response, treatment completion, and treatment satisfaction to an internet-delivered psychological pain management program for endometriosis. While no demographic or clinical predictors emerged, higher baseline psychological symptoms predicted clinical response. Findings suggest that such programs may be broadly suitable for patients with endometriosis.

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