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Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy versus Supportive Care for Chronic Back Pain.

Rutledge, Thomas PhD; Atkinson, J. Hampton MD; Chircop-Rollick, Tatiana PhD; D’Andrea, John; Garfin, Steven MD; Patel, Shetal PsyD; Penzien, Donald B. PhD; Wallace, Mark MD; Weickgenant, Anne L. PhD; Slater, Mark PhD
Clinical Journal of Pain: Post Acceptance: September 1, 2017
doi: 10.1097/AJP.0000000000000555
Original Article: PDF Only

Objective: To evaluate the efficacy of a telephone-delivered, home-based cognitive behavioral intervention for chronic low back pain in comparison to a matched supportive care treatment.

Methods: Participants (N=66) were patients with chronic back pain that were randomized to either an 8-week Cognitive-Behavioral Therapy (CBT) or a Supportive Care condition (SC) matched for contact frequency, format, and time. Participants completed validated measures of improvement in back pain disability, pain severity, and overall improvement.

Results: Intent-to-treat analyses at post-treatment showed that the treatment groups showed non-significantly different improvements in back pain disability (mean changes=-2.4 & -2.6 for CBT & SC, respectively; Cohen's d's=0.49 & 0.55, respectively) and reductions in pain severity (mean changes=-0.9 & -1.4 for CBT & SC respectively; Cohen's d's=0.50, & 0.90, respectively). Participants rated their overall improvement levels at 31% (CBT) versus 18.5% (SC).

Discussion: Results from this clinical trial suggest that home-based, telephone-delivered CBT and SC treatments did not significantly differ in their benefits for back pain severity and disability, and may warrant further research for applications to hospital settings. Major limitations included recruitment difficulties that underpowered primary analyses, the lack of objectives improvement measures, and the absence of a usual care/untreated control group for comparisons.

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