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Telephone-Delivered Cognitive Behavior Therapy for Chronic Pain

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00371267
First Posted: September 4, 2006
Last Update Posted: November 6, 2014
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
VA Office of Research and Development
  Purpose
The purpose of this study is to determine whether telephone-delivered cognitive behavior therapy is effective in the treatment of chronic pain. To examine the effectiveness of this approach, a two-arm randomized clinical trial was conducted with 98 individuals, 55 years of age and older, who suffered from chronic pain, recruited from a primary care clinic at the VA Medical Center in San Francisco and affiliated VA Community-based Outpatient Clinics (CBOCs) in Santa Rosa, San Bruno, Ukiah, and Eureka.

Condition Intervention
Pain Behavioral: Telephone-delivered Cognitive Behavior Therapy Other: Telephone-delivered Patient Education

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Telephone-Delivered Cognitive Behavior Therapy for Chronic Pain

Resource links provided by NLM:


Further study details as provided by VA Office of Research and Development:

Primary Outcome Measures:
  • Short Form-12 Physical Health [ Time Frame: 46 weeks ]
    Level of physical functioning in daily living, health-related quality of life Range: 0-100; higher score = higher functioning Score: Sum of weighted subscale scores

  • Short Form-12 Mental Health [ Time Frame: 46 weeks ]
    Daily functioning, quality of life Range: 0-100; higher scores = higher level of functioning Score: sum of weighted subscale scores


Secondary Outcome Measures:
  • Beck Depression Inventory (BDI)-2 Total Score [ Time Frame: 46 weeks ]
    Measure of symptoms of depression indicating severity of depression Total Score = sum of item scores Range: 0-63; higher scores = greater severity of depression

  • Pain Behavior Checklist Total Score [ Time Frame: 46 weeks ]
    Assessment of behavioral expression of pain Total Score = mean of item scores Range: 0-6; higher = more pain behavior

  • Pain Intensity Rating [ Time Frame: 46 weeks ]
    Measure of rated pain intensity Score = mean Range: 0-5; higher scores = more intense pain


Enrollment: 101
Study Start Date: October 2006
Study Completion Date: September 2010
Primary Completion Date: August 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1: Telephone-delivered CBT
Telephone-delivered cognitive behavior therapy for pain management
Behavioral: Telephone-delivered Cognitive Behavior Therapy
Telephone-delivered cognitive behavior therapy for pain management
Active Comparator: Arm 2: Telephone patient education
Telephone-delivered patient education regarding management of chronic pain
Other: Telephone-delivered Patient Education
Telephone-delivered patient education regarding chronic pain
Other Name: Patient education regarding pain management

Detailed Description:

Chronic pain represents an epidemic in the United States and a serious public health problem, particularly among adults over the age of 55. In the Veterans Health Administration (VHA), nearly 50% of patients seen in primary care settings report disabling pain symptoms. Persistent pain in older adults is often associated with disability, emotional distress, and increased health care utilization and cost. Since an increase in the number of older adults is anticipated over the next two decades, the problem of chronic pain in this age group will take on increased importance.

Although cognitive behavior therapy (CBT) aimed at improving coping skills is now commonly employed within interdisciplinary pain management programs, access to these interventions is often limited due to the distance from clinical care and disabling impact of pain. In addition, the dropout rate in studies of face-to-face CBT for chronic pain further detracts from its impact in pain management. A telephone-delivered version of CBT for chronic pain overcomes these barriers to access.

To examine the effectiveness of this approach, a two-arm randomized clinical trial was conducted with 98 individuals, 55 years of age and older, who suffered from chronic pain, recruited from a primary care clinic at the VA Medical Center in San Francisco and affiliated VA Community-based Outpatient Clinics (CBOCs) in Santa Rosa, San Bruno, Ukiah, and Eureka. In Study Arm 1, patients received telephone-based cognitive behavior therapy (T-CBT); and in Study Arm 2, patients received pain education (T-ED) matched with Study Arm 1 for amount of contact time. Patients in both groups received 12 sessions of telephone-based individual therapy over a 20-week period. Pain management outcomes were measured at mid-treatment (10 weeks), post-treatment (20 weeks), and at 3-month (32 weeks) and 6-month (46 weeks) follow-up. Outcome variables included measures of pain symptoms, physical limitations, coping, emotional distress, and health-related quality of life. The study hypothesis, assessment methodology, and intervention procedures were based on the cognitive-behavioral model of chronic pain

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   55 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Potential subjects must be:

  • veterans enrolled in a VA primary care clinic
  • at least 55 years of age
  • have access to a telephone
  • have documented pain for at least the past year
  • a pain disorder involving muscle strain and inflammation, trauma to nerves, or central nervous system dysfunction
  • Their pain condition must be stable and participants must have no clear indication for specific medical/surgical intervention.

Exclusion Criteria:

Patients were excluded who were:

  • psychotic
  • cognitively impaired
  • show significant suicidal risk (history of multiple suicide attempts or actively suicidal)
  • currently abusing alcohol or other drugs, including prescribed opioid pain medications
  • voice impairment that would prevent participation in telephone counseling
  • visual impairment that would prevent use of the workbook and completion of assessment materials.
  • Patients will also be excluded who have an unstable medical condition and clear indication for specific medical/surgical intervention in the near future.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00371267


Locations
United States, California
VA Medical Center, San Francisco
San Francisco, California, United States, 94121
Sponsors and Collaborators
VA Office of Research and Development
Investigators
Principal Investigator: Timothy Carmody, PhD VA Medical Center, San Francisco
  More Information

Publications:
Responsible Party: VA Office of Research and Development
ClinicalTrials.gov Identifier: NCT00371267     History of Changes
Other Study ID Numbers: F4281-I
First Submitted: August 31, 2006
First Posted: September 4, 2006
Results First Submitted: October 24, 2014
Results First Posted: November 6, 2014
Last Update Posted: November 6, 2014
Last Verified: October 2014

Keywords provided by VA Office of Research and Development:
cognitive behavioral therapy
pain

Additional relevant MeSH terms:
Chronic Pain
Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms