scholarly journals Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Kayoko Taguchi ◽  
Noriko Numata ◽  
Rieko Takanashi ◽  
Ryo Takemura ◽  
Tokiko Yoshida ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Brief Pain Inventory ◽  
Cognitive Behavioral ◽  
Pain Interference

BACKGROUND Cognitive behavioral therapy is known to improve the management of chronic pain. However, the components of this therapy are still being investigated and debated. OBJECTIVE This study aimed to examine the effectiveness of an integrated cognitive behavioral therapy program with new components (attention-shift, memory work, video feedback, and image training) delivered via videoconferencing. METHODS This study was unblinded and participants were recruited and assessed face-to-face in the outpatient department. We conducted a randomized controlled trial for chronic pain to compare 16 weekly videoconference-based cognitive behavioral therapy (vCBT) sessions provided by a therapist with treatment as usual (TAU). Thirty patients (age range, 22-75 years) with chronic pain were randomly assigned to either vCBT (n=15) or TAU (n=15). Patients were evaluated at week 1 (baseline), week 8 (midintervention), and week 16 (postintervention). The primary outcome was the change in pain intensity, which was recorded using the numerical rating scale at 16 weeks from the baseline. Secondary outcomes were pain severity and pain interference, which were assessed using the Brief Pain Inventory. Additionally, we evaluated disability, pain catastrophizing cognition, depression, anxiety, quality of life, and cost utility. RESULTS In the eligibility assessment, 30 patients were eventually randomized and enrolled; finally, 15 patients in the vCBT and 14 patients in the TAU group were analyzed. Although no significant difference was found between the 2 groups in terms of changes in pain intensity by the numerical rating scale scores at week 16 from baseline (<i>P</i>=.36), there was a significant improvement in the comprehensive evaluation of pain by total score of Brief Pain Inventory (–1.43, 95% CI –2.49 to –0.37, <i>df</i>=24; <i>P</i>=.01). Further, significant improvement was seen in pain interference by using the Brief Pain Inventory (–9.42, 95% CI –14.47 to –4.36, <i>df</i>=25; <i>P</i>=.001) and in disability by using the Pain Disability Assessment Scale (–1.95, 95% CI –3.33 to –0.56, <i>df</i>=24; <i>P</i>=.008) compared with TAU. As for the Medical Economic Evaluation, the incremental cost-effectiveness ratio for 1 year was estimated at 2.9 million yen (about US $25,000) per quality-adjusted life year gained. CONCLUSIONS The findings of our study suggest that integrated cognitive behavioral therapy delivered by videoconferencing in regular medical care may reduce pain interference but not pain intensity. Further, this treatment method may be cost-effective, although this needs to be further verified using a larger sample size. CLINICALTRIAL University Hospital Medical Information Network UMIN000031124; https://tinyurl.com/2pr3xszb

scholarly journals Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial

10.2196/30690 ◽  
2021 ◽  
Vol 23 (11) ◽  
pp. e30690
Author(s):  
Kayoko Taguchi ◽  
Noriko Numata ◽  
Rieko Takanashi ◽  
Ryo Takemura ◽  
Tokiko Yoshida ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Brief Pain Inventory ◽  
Cognitive Behavioral ◽  
Pain Interference

Background Cognitive behavioral therapy is known to improve the management of chronic pain. However, the components of this therapy are still being investigated and debated. Objective This study aimed to examine the effectiveness of an integrated cognitive behavioral therapy program with new components (attention-shift, memory work, video feedback, and image training) delivered via videoconferencing. Methods This study was unblinded and participants were recruited and assessed face-to-face in the outpatient department. We conducted a randomized controlled trial for chronic pain to compare 16 weekly videoconference-based cognitive behavioral therapy (vCBT) sessions provided by a therapist with treatment as usual (TAU). Thirty patients (age range, 22-75 years) with chronic pain were randomly assigned to either vCBT (n=15) or TAU (n=15). Patients were evaluated at week 1 (baseline), week 8 (midintervention), and week 16 (postintervention). The primary outcome was the change in pain intensity, which was recorded using the numerical rating scale at 16 weeks from the baseline. Secondary outcomes were pain severity and pain interference, which were assessed using the Brief Pain Inventory. Additionally, we evaluated disability, pain catastrophizing cognition, depression, anxiety, quality of life, and cost utility. Results In the eligibility assessment, 30 patients were eventually randomized and enrolled; finally, 15 patients in the vCBT and 14 patients in the TAU group were analyzed. Although no significant difference was found between the 2 groups in terms of changes in pain intensity by the numerical rating scale scores at week 16 from baseline (P=.36), there was a significant improvement in the comprehensive evaluation of pain by total score of Brief Pain Inventory (–1.43, 95% CI –2.49 to –0.37, df=24; P=.01). Further, significant improvement was seen in pain interference by using the Brief Pain Inventory (–9.42, 95% CI –14.47 to –4.36, df=25; P=.001) and in disability by using the Pain Disability Assessment Scale (–1.95, 95% CI –3.33 to –0.56, df=24; P=.008) compared with TAU. As for the Medical Economic Evaluation, the incremental cost-effectiveness ratio for 1 year was estimated at 2.9 million yen (about US $25,000) per quality-adjusted life year gained. Conclusions The findings of our study suggest that integrated cognitive behavioral therapy delivered by videoconferencing in regular medical care may reduce pain interference but not pain intensity. Further, this treatment method may be cost-effective, although this needs to be further verified using a larger sample size. Trial Registration University Hospital Medical Information Network UMIN000031124; https://tinyurl.com/2pr3xszb

scholarly journals A Novel Exercise Facilitation Method in Combination with Cognitive Behavioral Therapy Using the Ikiiki Rehabilitation Notebook for Intractable Chronic Pain: Technical Report and 22 Cases

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1209
Author(s):  
Shinji Kimura ◽  
Masako Hosoi ◽  
Naofumi Otsuru ◽  
Madoka Iwasaki ◽  
Takako Matsubara ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Rating Scale ◽  
School Attendance ◽  
Numerical Rating Scale ◽  
Pain Catastrophizing ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Technical Report ◽  
Numerical Rating

Recent clinical practice guidelines for chronic pain indicate, with a high evidence level, that the combination of exercise and cognitive behavioral therapy (CBT) is effective. The purpose of this study was to evaluate the effectiveness of an exercise facilitation method in combination with CBT using the “Ikiiki Rehabilitation Notebook” for patients with intractable chronic pain. “Ikiiki” means active in Japanese. A total of 22 cases with chronic low back (n = 13), lower extremity (n = 8), or neck (n = 1) pain were treated using this notebook. Two cases dropped out, leaving 22 cases. Each case was evaluated in terms of the numerical rating scale (NRS) of the pain, activities of daily living (ADL), pain catastrophizing scale (PCS), and quality of life (QOL) at pretreatment and post-treatment. The endpoint of the method was to achieve the long-term goals set by the patients. The mean treatment period was 11.2 months. The outcomes were as follows: improvement of presenteeism: nine cases; enhanced participation in hobbies: seven cases; improved school attendance: two cases; return to work: one case; improvement of self-care and/or self-efficacy: three cases. The NRS, ADL, PCS, and QOL were significantly improved after the treatment. This method is possibly valuable for educating patients about the cause and treatment of chronic pain and actively facilitating exercise and social participation. Further studies are needed to investigate the effectiveness of using this notebook for the patient with intractable chronic pain.

scholarly journals Randomized controlled trial on the effect of Internet-based Cognitive Behavioral Therapy with Real-Time Therapist Support Via a Video Conference for patients with chronic pain: A study protocol

2020 ◽  
Author(s):  
Kayoko Taguchi ◽  
Noriko Numata ◽  
Kana Kutsuzawa ◽  
Kensuke Yoshimura ◽  
Eiji Shimizu
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Usual Care ◽  
Real Time ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Video Conference ◽  
Randomized Controlled ◽  
Therapist Support

Abstract Background: Chronic pain, which persists for at least 12 weeks, is a serious medical condition that not only causes numerous physical and mental conditions, but also affects a person's entire life. Previous studies concerning cognitive behavioral therapy for patients with chronic pain have shown low to intermediate effectiveness. This paper describes the study protocol for a randomized controlled trial (RCT) to evaluate the effectiveness of our newly developed Internet-based Cognitive Behavioral Therapy with Real-Time Therapist Support Via a Video Conference (vCBT) as an adjunct to usual care compared with only usual care for chronic pain. Methods: The RCT comprises two parallel groups (vCBT + usual care and usual care alone) of 20 participants each (n=40) who were diagnosed with chronic pain. We aim to evaluate the effectiveness of the intervention over 16 weeks. The primary outcome is pain intensity, which will be assessed by the Numerical Rating Scale (NRS) at week 16. Secondary outcomes are pain catastrophic perception and daily life impairment degree, each assessed by the Pain Catastrophizing Scale (PCS) and Pain Disability Assessment Scale (PADS). In addition, anxiety, depression, and quality of life will be assessed. All measures will be assessed at weeks 1 (baseline), 8 (middle), and 16 (post). Discussion: This study aims to demonstrate the effectiveness of Internet-based CBT with Real-Time Therapist Support Via a Video Conference for patients with chronic pain. The findings of this study will show a feasibility and safety of online CBT for chronic pain, valuable addition to the treatment options for these patients. And we expect that many therapists will be able to universally provide CBT of comparable quality in the treatment of chronic pain by using the CBT protocol which we have developed.

scholarly journals The Effect of Cognitive-Behavioral Therapy on Pain Intensity in Patients with Chronic Pain

2015 ◽  
Vol 3 (3) ◽  
pp. 70-75 ◽  
Author(s):  
Pirhossein Kolivand ◽  
Azadeh Nazari Mahin ◽  
Robabeh Jafari ◽  
◽  
◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Pain Intensity ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

scholarly journals The Combinatorial Effects of Cognitive Behavioral Therapy with Aerobic Exercise in the Treatment of Fibromyalgia

2020 ◽  
Vol 3 ◽  
Author(s):  
Bryan Ko ◽  
Matthew Bair
Keyword(s):  
Pain Relief ◽  
Cognitive Behavioral Therapy ◽  
Aerobic Exercise ◽  
Pain Intensity ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Pain Interference ◽  
Pharmacological Interventions ◽  
The Us ◽  
Combinatorial Treatment

In the US alone, the chronic pain condition of fibromyalgia affects approximately 10 million people. Current treatment protocols focus heavily on pharmacological interventions; however, such treatments are unfavorable due to debilitating side effects and a lack of effectiveness in 2/3 of patients. Two non-pharmacological interventions which have been shown to produce meaningful pain relief are Cognitive Behavioral Therapy (CBT) and Aerobic Exercise. However, the combinatorial effects of these treatments have never been fully explored and it is unknown if these treatments interact in an additive manner or if the benefits of one negate the benefits of the other. In this work we conducted a literature review using the databases of Pubmed, OVID MEDLINE, PsychInfo, and Embase from 1995 to May 2020 to determine if the combinatorial effects of these two treatments on pain relief and pain interference are significantly greater than that of aerobic exercise alone. We reviewed over 200 potential articles for relevance. Seven papers were found to directly address our target question, two from the US and five from Europe with sample sizes ranging from 34 to 442. One paper showed improvement in pain intensity and two papers showed improvement in pain interference due to combinatorial treatment over aerobic exercise alone. When evaluating our results, we weighted these papers based on sample size, length of treatment and observation, method of CBT administration, and surveys chosen for data collection. We were unable to definitively show that CBT in combination with aerobic exercise is more effective than aerobic exercise alone at decreasing pain intensity and/or interference in patients with fibromyalgia. However, most of these papers identified several psychological and design based confounding factors that could influence their results. We recommend that more research be conducted in this area to further ascertain the effectiveness of this specific combinatorial treatment for fibromyalgia.  

Changes in resting-state brain networks after cognitive–behavioral therapy for chronic pain

2017 ◽  
Vol 48 (7) ◽  
pp. 1148-1156 ◽  
Author(s):  
A. Yoshino ◽  
Y. Okamoto ◽  
G. Okada ◽  
M. Takamura ◽  
N. Ichikawa ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Pain Intensity ◽  
Resting State ◽  
Clinical Symptoms ◽  
Behavioral Therapy ◽  
Brain Regions ◽  
Posterior Cingulate Cortex ◽  
Cognitive Behavioral ◽  
Connectivity Strength

AbstractBackgroundCognitive–behavioral therapy (CBT) is thought to be useful for chronic pain, with the pathology of the latter being closely associated with cognitive–emotional components. However, there are few resting-state functional magnetic resonance imaging (R-fMRI) studies. We used the independent component analysis method to examine neural changes after CBT and to assess whether brain regions predict treatment response.MethodsWe performed R-fMRI on a group of 29 chronic pain (somatoform pain disorder) patients and 30 age-matched healthy controls (T1). Patients were enrolled in a weekly 12-session group CBT (T2). We assessed selected regions of interest that exhibited differences in intrinsic connectivity network (ICN) connectivity strength between the patients and controls at T1, and compared T1 and T2. We also examined the correlations between treatment effects and rs-fMRI data.ResultsAbnormal ICN connectivity of the orbitofrontal cortex (OFC) and inferior parietal lobule within the dorsal attention network (DAN) and of the paracentral lobule within the sensorimotor network in patients with chronic pain normalized after CBT. Higher ICN connectivity strength in the OFC indicated greater improvements in pain intensity. Furthermore, ICN connectivity strength in the dorsal posterior cingulate cortex (PCC) within the DAN at T1 was negatively correlated with CBT-related clinical improvements.ConclusionsWe conclude that the OFC is crucial for CBT-related improvement of pain intensity, and that the dorsal PCC activation at pretreatment also plays an important role in improvement of clinical symptoms via CBT.

scholarly journals Peer-delivered Cognitive Behavioral Therapy-based Intervention Reduced Depression and Stress in Community Dwelling Adults With Diabetes and Chronic Pain: A Cluster Randomized Trial

2021 ◽  
Author(s):  
Susan J Andreae ◽  
Lynn J Andreae ◽  
Joshua S Richman ◽  
Andrea L Cherrington ◽  
Monika M Safford
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Perceived Stress ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Cognitive Behavioral ◽  
Community Members ◽  
Cluster Randomized

Abstract Background Finding effective, accessible treatment options such as professional-delivered cognitive behavioral therapy (CBT) for medically complex individuals is challenging in rural communities. Purpose We examined whether a CBT-based program intended to increase physical activity despite chronic pain in patients with diabetes delivered by community members trained as peer coaches also improved depressive symptoms and perceived stress. Methods Participants in a cluster-randomized controlled trial received a 3-month telephonic lifestyle modification program with integrated CBT elements. Peer coaches assisted participants in developing skills related to adaptive coping, diabetes self-management goal-setting, stress reduction, and cognitive restructuring. Attention controls received general health advice with an equal number of contacts but no CBT elements. Depressive symptoms and stress were assessed using the Centers for Epidemiologic Studies Depression and Perceived Stress scales. Assessments occurred at baseline, 3 months, and 1 year. Results Of 177 participants with follow-up data, 96% were African Americans, 79% women, and 74% reported annual income &lt;$20,000. There was a significant reduction in perceived stress in intervention compared to control participants at 3-months (β = −2.79, p = .002 [95% CI −4.52, −1.07]) and 1 year (β = −2.59, p &lt; .0001 [95% CI −3.30, −1.87]). Similarly, intervention participants reported significant decreases in depressive symptoms at 3-months (β = −2.48, p &lt; .0001 [95% CI −2.48, −2.02]) and at 1 year (β = −1.62, p &lt; .0001 [95% CI −2.37, −0.86]). Conclusions This peer-delivered CBT-based program improved depressive symptoms and stress in individuals with diabetes and chronic pain. Training community members may be a feasible strategy for offering CBT-based interventions in rural and under-resourced communities. Clinical Trial Registration NCT02538055.

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