Cognitive behavioural therapy CBT over the phone is shown to help chronic widespread pain
Last updated 11/17/2011 12:58:15 PM
Cognitive behavioural therapy CBT over the phone is shown to help chronic widespread pain
Patients who received a short course of cognitive behavioural therapy (CBT) over the telephone from trained therapists reported that they felt "better" or "very much better" at the end of a six-month treatment period, and also three months after.
The trial, funded by Arthritis Research UK , was the first-ever trial of telephone-delivered CBT for people with chronic widespread pain.
Cognitive behavioural therapy is a psychological method of helping people manage their pain by identifying and evaluating thoughts and behaviour. Exercise was also shown to improve pain and disability and helped people manage their symptoms.
The trial, involving 442 people with chronic widespread pain aged between 25 and 60 from GP surgeries in Cheshire and Aberdeen, aimed to develop more effective ways of reducing and/or coping with painful symptoms.
The study was led by Professor Gary Macfarlane, professor of epidemiology at the University of Aberdeen and Dr John McBeth, reader in rheumatic disease epidemiology at the Arthritis Research UK Epidemiology Unit at The University of Manchester.
Professor Macfarlane commented: "These results demonstrate that we can improve symptoms for many people."
Professor Alan Silman, medical director of Arthritis Research UK, said: "Persistent severe aching felt all over the body is an all too common disorder which frustrates patients and health care professionals alike and is not easily controlled by pain killers. This trial has shown how a behavioural approach can help people cope with the pain in a feasible and affordable manner. The National Institute for Health and Clinical Excellence (NICE) and health care providers will be most interested to build on the success of this trial."
In the trial patients were split into groups: one group doing exercise, a second receiving CBT, a third receiving a combination of both and a fourth group who were given the "usual care" by their GP.
The exercise group was offered six fitness instructor-led monthly appointments and were recommended to exercise between 20 and 60 minutes a day with increasing intensity over the six-month period. Outcomes were measured by self-completing postal questionnaires using a seven-point patient global assessment scale on patients' health from the time of enrolling on the trial, ranging from "very much worse" to "very much better." Assessments were made at six months, when treatment ended, and three months later. A positive outcome was defined as "much better" or "very much better."
Telephone CBT and exercise were both associated with substantial, statistically significant, clinically meaningful improvements in self-rated global health.The researchers also found that participants who expressed a preference for one or the other of the treatments did better if they got their preferred treatment.