Challenges and visions for managing pain-related insomnia in primary care using the hybrid CBT approach: a small-scale qualitative interview study with GPs, nurses, and practice managers
Abstract:Background
Chronic pain and insomnia have a complex, bidirectional relationship – addressing sleep complaints alongside pain may be key to alleviating patient-reported distress and disability. Healthcare professionals have consistently reported wanting to offer psychologically informed chronic pain management at the primary care level. Research in secondary care has demonstrated good treatment efficacy of hybrid CBT for chronic pain and insomnia. However, primary care is typically the main poin… Show more
“…Access to behavioral providers with specialization in behavioral pain or headache treatments can be challenging, particularly in rural settings [ 40 ]. Therefore, patients may face limited options in behavioral treatment providers, resulting in limited behavioral treatment strategies that may not adequately address their specific treatment needs [ 41 , 42 ]. Recent studies have observed greater use of telemedicine for patients who receive specialty pain services in rural populations (12%) compared to urban patients (3%) [ 43 ].…”
Section: Mitigating Barriers and Improving Access To Carementioning
Purpose of Review
The purpose of this review is to summarize advances in behavioral treatments for pain and headache disorders, as well as recent innovations in telemedicine for behavioral treatments.
Recent Findings
Research for behavioral treatments continues to support their use as part of a multidisciplinary approach to comprehensive management for pain and headache conditions. Behavioral treatments incorporate both behavioral change and cognitive interventions and have been shown to improve outcomes beyond that of medical management alone. The onset of the COVID-19 public health emergency necessitated the rapid uptake of nontraditional modalities for behavioral treatments, particularly telemedicine. Telemedicine has long been considered the answer to several barriers to accessing behavioral treatments, and as a result of COVID-19 significant progress has been made evaluating a variety of telemedicine modalities including synchronous, asynchronous, and mobile health applications. Researchers are encouraged to continue investigating how best to leverage these modalities to improve access to behavioral treatments and to continue evaluating the efficacy of telemedicine compared to traditional in-person care.
Summary
Comprehensive pain and headache management should include behavioral treatments to address a variety of behavior change and cognitive targets. Policy changes and advances in telemedicine for behavioral treatments provide the opportunity to address historical barriers limiting access.
“…Access to behavioral providers with specialization in behavioral pain or headache treatments can be challenging, particularly in rural settings [ 40 ]. Therefore, patients may face limited options in behavioral treatment providers, resulting in limited behavioral treatment strategies that may not adequately address their specific treatment needs [ 41 , 42 ]. Recent studies have observed greater use of telemedicine for patients who receive specialty pain services in rural populations (12%) compared to urban patients (3%) [ 43 ].…”
Section: Mitigating Barriers and Improving Access To Carementioning
Purpose of Review
The purpose of this review is to summarize advances in behavioral treatments for pain and headache disorders, as well as recent innovations in telemedicine for behavioral treatments.
Recent Findings
Research for behavioral treatments continues to support their use as part of a multidisciplinary approach to comprehensive management for pain and headache conditions. Behavioral treatments incorporate both behavioral change and cognitive interventions and have been shown to improve outcomes beyond that of medical management alone. The onset of the COVID-19 public health emergency necessitated the rapid uptake of nontraditional modalities for behavioral treatments, particularly telemedicine. Telemedicine has long been considered the answer to several barriers to accessing behavioral treatments, and as a result of COVID-19 significant progress has been made evaluating a variety of telemedicine modalities including synchronous, asynchronous, and mobile health applications. Researchers are encouraged to continue investigating how best to leverage these modalities to improve access to behavioral treatments and to continue evaluating the efficacy of telemedicine compared to traditional in-person care.
Summary
Comprehensive pain and headache management should include behavioral treatments to address a variety of behavior change and cognitive targets. Policy changes and advances in telemedicine for behavioral treatments provide the opportunity to address historical barriers limiting access.
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