Journal article
Web-Based Cognitive Behavior Therapy for Chronic Pain Patients with Aberrant Drug-Related Behavior: Outcomes from a Randomized Controlled Trial
Pain medicine (Malden, Mass.), v 19(12), pp 2423-2437
01 Dec 2018
PMID: 29346579
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Abstract
Objective
There is high unmet need for effective behavioral treatments for chronic pain patients at risk for or with demonstrated histories of opioid misuse. Despite growing evidence supporting technology-based delivery of self-management interventions for chronic pain, very few such programs target co-occurring chronic pain and aberrant drug-related behavior. This randomized controlled trial evaluated the effectiveness of a novel, web-based self-management intervention, grounded in cognitive behavior therapy, for chronic pain patients with aberrant drug-related behavior.
Methods
Opioid-treated chronic pain patients at a specialty pain practice who screened positive for aberrant drug-related behavior (N = 110) were randomized to receive treatment as usual plus the web-based program or treatment as usual alone. The primary outcomes of pain severity, pain interference, and aberrant drug-related behavior, and the secondary outcomes of pain catastrophizing and pain-related emergency department visits, were assessed during the 12-week intervention and at one and three months postintervention.
Results
Patients assigned to use the web-based program reported significantly greater reductions in aberrant drug-related behavior, pain catastrophizing, and pain-related emergency department visits—but not pain severity or pain interference—relative to those assigned to treatment as usual. The positive outcomes were observed during the 12-week intervention and for three months postintervention.
Conclusions
A web-based self-management program, when delivered in conjunction with standard specialty pain treatment, was effective in reducing chronic pain patients’ aberrant drug-related behavior, pain catastrophizing, and emergency department visits for pain. Technology-based self-management tools may be a promising therapeutic approach for the vulnerable group of chronic pain patients who have problems managing their opioid medication.
Metrics
Details
- Title
- Web-Based Cognitive Behavior Therapy for Chronic Pain Patients with Aberrant Drug-Related Behavior: Outcomes from a Randomized Controlled Trial
- Creators
- Honoria Guarino - National Development and Research InstitutesChunki Fong - National Development and Research InstitutesLisa A Marsch - Dartmouth CollegeMichelle C Acosta - National Development and Research InstitutesCassandra Syckes - National Development and Research InstitutesSarah K Moore - AcumenRicardo A Cruciani - Drexel UniversityRussell K Portenoy - MJHS Institute for Innovation in Palliative Care, New York, New York.Dennis C Turk - University of WashingtonAndrew Rosenblum - National Development and Research InstitutesChristos D Katsetos
- Publication Details
- Pain medicine (Malden, Mass.), v 19(12), pp 2423-2437
- Publisher
- Oxford University Press
- Grant note
- R01DA026887 / National Institutes of Health (10.13039/100000002) US National Institute on Drug Abuse
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:000454336200011
- Scopus ID
- 2-s2.0-85058880661
- Other Identifier
- 991019353718404721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Anesthesiology