B McCarberg1, J Wolf. 1. Kaiser Permanente, San Diego, California, USA.
Abstract
OBJECTIVE: The purpose of this study is to investigate the management of chronic pain in a large health maintenance organization using cognitive-behavioral techniques and a blinded control group. DESIGN: Subjects were randomized into two groups. All participants completed a self-administered baseline questionnaire and were mailed a self-administered 6-month follow-up questionnaire. SETTING: This study examines chronic pain management in a large, established health maintenance organization. PATIENTS: Patients were members of a health maintenance organization, had pain for at least 6 months, and had failed all known treatment regimens. INTERVENTIONS: The treatment group participated in a 16-hour, 8-week class teaching cognitive-behavioral techniques, the relaxation response, meditation, and stress management. The minimal treatment group received a home-study manual. OUTCOME MEASURES: Behavioral outcomes, function, and pain severity and also patient satisfaction were measured. RESULTS: Both the treatment and minimal treatment groups exhibited improvement in pain severity, negative mood, pain affect, and pain interference with the patient's life. CONCLUSION: Gains were achieved in pain severity, negative mood, pain affect, self-control, and pain interference with the patient's life. Other behavioral variables and activity did not improve. Except in self-control, pain affect, and distracting responses from their significant others, the blinded minimal treatment group demonstrated similar findings. Patient satisfaction with treatment strongly favored the treatment group with over 78% of the treatment participants satisfied with the care provided.
RCT Entities:
OBJECTIVE: The purpose of this study is to investigate the management of chronic pain in a large health maintenance organization using cognitive-behavioral techniques and a blinded control group. DESIGN: Subjects were randomized into two groups. All participants completed a self-administered baseline questionnaire and were mailed a self-administered 6-month follow-up questionnaire. SETTING: This study examines chronic pain management in a large, established health maintenance organization. PATIENTS: Patients were members of a health maintenance organization, had pain for at least 6 months, and had failed all known treatment regimens. INTERVENTIONS: The treatment group participated in a 16-hour, 8-week class teaching cognitive-behavioral techniques, the relaxation response, meditation, and stress management. The minimal treatment group received a home-study manual. OUTCOME MEASURES: Behavioral outcomes, function, and pain severity and also patient satisfaction were measured. RESULTS: Both the treatment and minimal treatment groups exhibited improvement in pain severity, negative mood, pain affect, and pain interference with the patient's life. CONCLUSION: Gains were achieved in pain severity, negative mood, pain affect, self-control, and pain interference with the patient's life. Other behavioral variables and activity did not improve. Except in self-control, pain affect, and distracting responses from their significant others, the blinded minimal treatment group demonstrated similar findings. Patient satisfaction with treatment strongly favored the treatment group with over 78% of the treatment participants satisfied with the care provided.
Authors: Gianluca Castelnuovo; Emanuele M Giusti; Gian Mauro Manzoni; Donatella Saviola; Arianna Gatti; Samantha Gabrielli; Marco Lacerenza; Giada Pietrabissa; Roberto Cattivelli; Chiara A M Spatola; Stefania Corti; Margherita Novelli; Valentina Villa; Andrea Cottini; Carlo Lai; Francesco Pagnini; Lorys Castelli; Mario Tavola; Riccardo Torta; Marco Arreghini; Loredana Zanini; Amelia Brunani; Paolo Capodaglio; Guido E D'Aniello; Federica Scarpina; Andrea Brioschi; Lorenzo Priano; Alessandro Mauro; Giuseppe Riva; Claudia Repetto; Camillo Regalia; Enrico Molinari; Paolo Notaro; Stefano Paolucci; Giorgio Sandrini; Susan G Simpson; Brenda Wiederhold; Stefano Tamburin Journal: Front Psychol Date: 2016-02-19
Authors: Robert C Smith; Catherine Lein; Clare Collins; Judith S Lyles; Barbara Given; Francesca C Dwamena; John Coffey; AnneMarie Hodges; Joseph C Gardiner; John Goddeeris; C William Given Journal: J Gen Intern Med Date: 2003-06 Impact factor: 5.128
Authors: Paul R Chelminski; Timothy J Ives; Katherine M Felix; Steven D Prakken; Thomas M Miller; J Stephen Perhac; Robert M Malone; Mary E Bryant; Darren A DeWalt; Michael P Pignone Journal: BMC Health Serv Res Date: 2005-01-13 Impact factor: 2.655