HealthDay News — For adults with chronic pain conditions receiving long-term opioid therapy, a cognitive behavioral therapy (CBT) intervention produces modest, but sustained, reductions in measures of pain and pain-related disability, according to a study published online Nov. 2 in the Annals of Internal Medicine.

Lynn DeBar, Ph.D., M.P.H., from the Kaiser Permanente Washington Health Research Institute in Seattle, and colleagues conducted a pragmatic, cluster randomized trial to examine the effectiveness of a group-based CBT intervention for chronic pain. A total of 850 adults with mixed chronic pain conditions receiving long-term opioid therapy were randomly assigned to a CBT intervention teaching pain self-management skills in 12 weekly groups versus usual care; 96 percent completed follow-up assessments.

The researchers found that on all self-reported outcomes, intervention patients sustained larger reductions from baseline to 12-month follow-up: The change in the pain intensity and interference with enjoyment of life, general activity, and sleep score was −0.434 points for pain impact, while the change was −0.060 points for pain-related disability. Intervention patients reported higher satisfaction with primary care (difference, 0.230 points) and pain services (difference, 0.336 points) at six months. The intervention group had more of a decrease in benzodiazepine use (absolute risk difference, −0.055), but there was no difference between the groups in opioid use.


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“This study shows the potential for skill-based, CBT interventions delivered by frontline clinicians to reduce pain impact and improve function among patients with chronic pain receiving long-term opioid treatment,” the authors write. “Although effects were modest, they persisted after treatment through final 12-month follow-up.”

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