Randomized Controlled Trial of Nurse-Delivered Cognitive-Behavioral Therapy Versus Supportive Psychotherapy Telehealth Interventions for Chronic Back Pain

Rutledge, Thomas; Atkinson, J. Hampton; Holloway, Rachael; Chircop-Rollick, Tatiana; D'Andrea, John A.; Garfin, Steven R.; Patel, Shetal; Penzien, Donald; Wallace, Mark; Weickgenant, Anne L.; Slater, Mark A.

doi:10.1016/j.jpain.2018.03.017

Cited by 24 publications

(39 citation statements)

References 23 publications

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“…In this analysis, the pre‐ to post‐treatment reductions in pain intensity and pain interference observed were consistent with those demonstrated in other behavioral therapy interventions in chronic pain populations at or around 8 weeks. In a 2018 randomized controlled clinical trial, Rutledge et al documented that cognitive behavioral therapy for lower back pain delivered by telephone was associated with significant improvement in pain interference and an approximately 1.2‐point (24%) reduction in pain intensity, with more than 33% of participants achieving a ≥30% reduction in pain intensity on a numeric rating scale of 0 to 10 at 8 weeks . Similar reductions in pain intensity and pain interference have also been shown in randomized trials of behavioral therapy for pain in other settings and via other delivery modalities (eg, nurses vs. therapists, group vs. individual, face‐to‐face vs. virtual) .…”

Section: Discussionmentioning

confidence: 73%

“…Solutions to established access barriers could lead to improved clinical and workplace outcomes for the millions living with chronic pain and/or behavioral health conditions. Virtual behavioral therapy (ie, evidence‐based behavioral therapy provided by a licensed therapist over secure telephone or video) has gained recognition as an effective and noninferior treatment delivery mechanism for depression and chronic pain that can address these known challenges …”

Section: Introductionmentioning

confidence: 99%

“…Virtual behavioral therapy (ie, evidence-based behavioral therapy provided by a licensed therapist over secure telephone or video) has gained recognition as an effective and noninferior treatment delivery mechanism for depression and chronic pain that can address these known challenges. [11][12][13][14] Few data describe real-world outcomes from standardized virtual behavioral therapy programs for chronic pain delivered at a national scale. The purpose of this study was to describe clinical and workplace outcomes from an evidence-based, virtual behavioral therapy program for individuals with pain and behavioral health issues in the United States.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Workplace Outcomes From a Virtually Delivered Cognitive Behavioral Therapy Program for Pain

Mochari‐Greenberger¹,

Andreopoulos²,

Peters³

et al. 2020

Pain Practice

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Objectives To evaluate clinical and workplace outcomes from an evidence‐based virtual behavioral therapy program for individuals with pain and behavioral health issues. Methods This was a retrospective de‐identified data analysis among a cohort of 1,086 participants enrolled in a standardized, evidence‐based telebehavioral therapy program between September 1, 2016, and August 31, 2017 (mean age 53 ± 11.5 years; 29% male). The program was delivered over approximately 8 weeks by licensed therapists and behavior coaches by telephone or video, and tailored to the pain management and behavioral health goals of each participant. Structured measurements were documented in the electronic clinical record, including demographics, comorbidities, pain severity (Pain Intensity, Enjoyment of Life, General Activity tool), behavioral health symptoms (Depression, Anxiety and Stress Scale short form), and productivity (Work Productivity and Activity Impairment survey). Results At baseline, participants had high average pain severity (5.8/10 points), high frequencies of behavioral health symptoms (68%), and activity impairment (90%); absenteeism (34%) and presenteeism (75%) were observed among employed individuals. Pain severity and pain interference improved by 17% and 27%, respectively, over 8 weeks (P < 0.0001). Reductions in depression, anxiety, and stress symptoms were significant and associated with reductions in pain interference (P < 0.0001). Absenteeism, presenteeism, and activity impairment ratings each improved by more than 25% (P < 0.0001). Discussion Participants in a virtually delivered behavioral therapy program for pain experienced significant improvements in pain intensity, pain interference, behavioral health symptoms, and work productivity.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and Workplace Outcomes From a Virtually Delivered Cognitive Behavioral Therapy Program for Pain

Mochari‐Greenberger¹,

Andreopoulos²,

Peters³

et al. 2020

Pain Practice

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“…There was also no greater benefit regarding interventions provided by nurses on interventions that required strong patient and caregiver relationships. 8 The research parameters used to measure the success rate of the interventions were quite comprehensive, some of which were pain intensity, physical function, psychological pressure, disability, fatigue, quality of life, coping strategies, catastrophization, and depression. In addition to measuring the results of pain, there were studies that have also tested mediators that affect pain relief related to the intervention given.…”

Section: Resultsmentioning

confidence: 99%

“…Exclusion criteria were also important to rule out bias factors such as patients who already have primary medical conditions (e.g., chronic obstructive pulmonary disease, congestive heart failure) that could interfere with pain. 8,12 Research by Dyke, et al (2019) mentioned that patients with lack of education, cognitive, and literacy have benefited greatly from CBT compared to educational therapy that has focused on group discussions. CBT was more structured, directed, and provided more concrete skills training than educational care.…”

Section: Resultsmentioning

confidence: 99%

Cognitive Behavioral Therapy for Chronic Pain

Afrina

Karimah

2019

BHSJ

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Introduction: Pain is a complex stressor that has a major influence on several aspects of a person's physical, psychological, work and financial functions, especially in the form of chronic pain. The approach to chronic pain medically can sometimes not solve the problem as a whole, so that in its management psychological approaches such as cognitive and behavioral therapy (CBT) are needed.Methods: We searched PubMed, Science Direct, and Google Scholar for search articles in English terms "chronic pain", "cognitive behavioral therapy", "pain management", and "efficacy". Searching using the keywords above showed 40 articles, but which were taken were 8 articles from the last 5 years.Results: The method of intervention was carried out with a cognitive-behavioral approach in the form of traditional CBT, telephone-based CBT, coping skills training, cognitive-behavioral based physical therapy or CBT-based self-management. The research parameters used to measure the success rate of the interventions were pain intensity, physical function, psychological pressure, disability, fatigue, quality of life, coping strategies, catastrophization, and depression. The duration of the study varied from 5 weeks to 10 weeks, with a variation of 20-60 minutes per therapy session, except in studies using group therapy can take up to 5-7 hours per day. Some studies also conducted evaluation at the third and six months after treatment. The aim of the CBT approach was to independently improve self-efficacy in pain management.Conclusion: Cognitive behavioral approaches combined with other therapeutic modalities can improve the physical function of patients with chronic pain.

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