Jeanne M Hoffman1, Dawn M Ehde2, Sureyya Dikmen3, Tiara Dillworth4, Kevin Gertz5, Carrie Kincaid6, Sylvia Lucas7, Nancy Temkin8, Kate Sawyer9, Rhonda Williams10. 1. Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, Washington 98195-6490, USA. Electronic address: jeanneh@uw.edu. 2. Department of Rehabilitation Medicine, Box 359612, University of Washington, Seattle, Washington 98104, USA. Electronic address: ehde@uw.edu. 3. Department of Rehabilitation Medicine, Box 359612, University of Washington, Seattle, Washington 98104, USA; Department of Neurological Surgery, Box 359924, University of Washington, Seattle, Washington 98104, USA. Electronic address: dikmen@uw.edu. 4. Department of Rehabilitation Medicine, Box 359612, University of Washington, Seattle, Washington 98104, USA. Electronic address: tiara@uw.edu. 5. Department of Rehabilitation Medicine, Box 359612, University of Washington, Seattle, Washington 98104, USA. Electronic address: kjgertz@uw.edu. 6. VA Puget Sound Healthcare System, 1660 S. Columbian Way, RCS-117, Seattle, WA 98108, USA. Electronic address: Carrie.Kincaid@va.gov. 7. Department of Neurological Surgery, Box 359924, University of Washington, Seattle, Washington 98104, USA. Electronic address: lucass@uw.edu. 8. Department of Rehabilitation Medicine, Box 359612, University of Washington, Seattle, Washington 98104, USA; Department of Neurological Surgery, Box 359924, University of Washington, Seattle, Washington 98104, USA. Electronic address: temkin@uw.edu. 9. Department of Psychology, Western Washington Medical Group, 3525 Colby Ave, Suite 200, Everett, WA 98201, USA. 10. Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, Washington 98195-6490, USA; VA Puget Sound Healthcare System, 1660 S. Columbian Way, RCS-117, Seattle, WA 98108, USA. Electronic address: Rhonda.williams1@va.gov.
Abstract
BACKGROUND AND OBJECTIVES:Chronic pain is a highly prevalent and potentially disabling condition in Veterans who have had a traumatic brain injury (TBI) and access to non-pharmacological pain treatments such as cognitive behavioral therapy is limited and variable. The purpose of this randomized controlled trial (RCT) is to evaluate the efficacy of a telephone-delivered cognitive behavioral therapy (T-CBT) for pain in Veterans with a history of TBI. METHODS:Veterans with a history of TBI and chronic pain of at least six months duration (N = 160) will be randomized to either T-CBT or a telephone-delivered pain psychoeducational active control condition (T-Ed). The eight-week T-CBT intervention builds on other efficacious CBT interventions for chronic pain in the general population but is novel in that it is conducted via telephone and adapted for Veterans with a history of TBI. Outcome variables will be collected pre, mid-, and post-treatment, and 6 months following randomization (follow-up). PROJECTED OUTCOMES: In addition to evaluating the effects of the interventions on pain intensity (primary outcome), this study will determine their effects on pain interference, sleep, depression, and life satisfaction. We will also examine potential moderators of treatment outcomes such as cognition, PTSD, and alcohol and drug use. This non-pharmacologic one-on-one therapeutic intervention has the potential to reduce pain and pain-related dysfunction, improve access to care, and reduce barriers associated with geography, finances, and stigma, without the negative effects on physical and cognitive performance and potential for addiction as seen with some pharmacologic treatments for pain. This trial is registered at ClinicalTrials.gov, protocol NCT01768650.
RCT Entities:
BACKGROUND AND OBJECTIVES:Chronic pain is a highly prevalent and potentially disabling condition in Veterans who have had a traumatic brain injury (TBI) and access to non-pharmacological pain treatments such as cognitive behavioral therapy is limited and variable. The purpose of this randomized controlled trial (RCT) is to evaluate the efficacy of a telephone-delivered cognitive behavioral therapy (T-CBT) for pain in Veterans with a history of TBI. METHODS: Veterans with a history of TBI and chronic pain of at least six months duration (N = 160) will be randomized to either T-CBT or a telephone-delivered pain psychoeducational active control condition (T-Ed). The eight-week T-CBT intervention builds on other efficacious CBT interventions for chronic pain in the general population but is novel in that it is conducted via telephone and adapted for Veterans with a history of TBI. Outcome variables will be collected pre, mid-, and post-treatment, and 6 months following randomization (follow-up). PROJECTED OUTCOMES: In addition to evaluating the effects of the interventions on pain intensity (primary outcome), this study will determine their effects on pain interference, sleep, depression, and life satisfaction. We will also examine potential moderators of treatment outcomes such as cognition, PTSD, and alcohol and drug use. This non-pharmacologic one-on-one therapeutic intervention has the potential to reduce pain and pain-related dysfunction, improve access to care, and reduce barriers associated with geography, finances, and stigma, without the negative effects on physical and cognitive performance and potential for addiction as seen with some pharmacologic treatments for pain. This trial is registered at ClinicalTrials.gov, protocol NCT01768650.
Authors: Lauren B Fisher; Sylvie Tuchman; Andrew J Curreri; Maggie Markgraf; Maren B Nyer; Paolo Cassano; Grant L Iverson; Maurizio Fava; Ross D Zafonte; Paola Pedrelli Journal: JMIR Form Res Date: 2021-12-01