Ignite Creation Date:
2024-05-06 @ 11:21 AM
Last Modification Date:
2024-10-26 @ 12:43 PM
Study NCT ID:
NCT03490981
Status:
COMPLETED
Last Update Posted:
2021-03-03
First Post:
2018-03-30
Brief Title:
Brief Cognitive Behavioral Therapy for Chronic Pain
Sponsor:
VA Office of Research and Development
Organization:
VA Office of Research and Development
Study Overview
Official Title:
RCT of Brief Cognitive Behavioral Therapy for Chronic Pain
Status:
COMPLETED
Status Verified Date:
2021-02
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Brief Cognitive Behavioral Therapy for Chronic Pain Brief CBT-CP is designed specifically for use in integrated care settings The first objective of the proposed study is to conduct a pilot randomized controlled trial of Brief CBT-CP compared to primary care treatment as usual to assess feasibility ie recruitment and retention of participants appropriateness of measures and assessment of fidelity of service delivery This trial will also preliminarily assess treatment effectiveness by examining changes in pain-related physical interference psychological distress pain intensity and other related outcomes Thirty eligible participants will be randomized into either Brief CBT-CP and primary care treatment as usual or primary care treatment as usual only Eligible Veterans will include those with chronic musculoskeletal pain and pain-related functional impairment identified from primary care Participants assigned to Brief CBT-CP will receive six sessions of treatment in 30-minute appointments This intervention will include education and goal setting activities and pacing relaxation skills cognitive coping and relapse prevention Assessments will include validated self-report measures that will take place at pre-treatment baseline post-treatment and at 12-week follow-up The second objective of this study will be to explore patient and provider perceptions of Brief CBT-CP to identify potential modifications that will improve its quality and overall feasibility of delivery in future work Participants will include up to 12 staff members as well as up to 12 patients who were randomized to Brief CBT-CP Participants will be interviewed by telephone about key components of the treatment Participants will comment on protocol and procedures in terms of acceptability the perception that a treatment is agreeable or that its specific components are satisfactory appropriateness the perceived fit or compatibility of the intervention for a given provider or consumer and feasibility the extent to which a new treatment can be successfully carried out or is suitable for everyday use This intervention has clear implications for translation to clinical practice and for improving pain care quality by providing an evidence-based protocol The potential direct benefit to Veterans includes offering a safe accessible non-pharmacological treatment for chronic pain early in the trajectory of care
Detailed Description:
We will recruit 30 Veterans from the primary care clinics located at the Buffalo Veterans Affairs medical center in Buffalo New York Thirty eligible participants will be randomized in a 11 ratio into either 1 Brief Cognitive Behavioral Therapy for Chronic Pain Brief CBT-CP plus treatment as usual TAU or 2 TAU only We will engage in recruitment during the second quarter of Year 1 through the end of the first quarter of Year 2 We aim to recruit and enroll 7-8 participants per quarter during that time frame Post-treatment follow-up will be conducted at eight weeks and at 12 weeks Two recruitment methods will be used Veterans with chronic musculoskeletal pain who self-report functional impairment will be referred by their primary care team in response to a recruitment flyer posted in primary care or by contacting the principal investigator or study staff directly after hearing of the study by word of mouth or other sources This approach will be supplemented by a case-finding procedure in which study staff review electronic medical record data to identify potential patients who will be subsequently contacted by letter and screened by telephone Following telephone screening potentially eligible participants will complete a baseline assessment to assess pain and related characteristics as well as remaining exclusion criteria Those passing baseline measures will be randomized to 1 Brief CBT-CP plus TAU or 2 TAU only Assignment to Brief CBT-CP will be stratified based on degree of pain interference
Brief CBT-CP is a manualized protocol that includes six 30-minute sessions over the course of 6 weeks Brief CBT-CP session outlines and patient handouts are included in the appendix Session one focuses on foundational pain education and the development of treatment goals Session two emphasizes balanced engagement in physical activity and pleasurable events Session three emphasizes skills training for easily implemented relaxation techniques Sessions four and five focus on recognizing and modifying unhelpful thoughts that negatively impact pain Session six focuses on relapse prevention and independent implementation of CBT-CP skills following treatment Brief CBT-CP will be delivered by a masters-level interventionist either at the medical center or by telephone depending on the preference of the participant
Participants assigned to TAU only will receive standard medical care from their primary care provider including pain medications brief advice eg use of relative rest application of heat or ice other self-care strategies or referral to pain-related adjunctive interventions eg physical therapy as indicated Participants in TAU only will not receive behavioral intervention from the primary care clinic behavioral health provider
We will conduct brief interviews with up to 24 purposefully selected participants ie 12 providers and 12 patients The provider group will include 6 primary care providers and 6 behavioral health providers I providers who staff Veterans Affairs primary care clinics Interview items are based on implementation constructs relevant for early stage intervention development acceptability or agreeableness and satisfaction with treatment components appropriateness or perceived fitcompatibility of the intervention and feasibility or whether the intervention is suitable for use Up to 12 patients who were randomized to Brief CBT-CP will be asked to complete a 30-minute interviews ie telephone or face-to-face depending on participant preference following their 12-week assessment as described in the consent procedures prior to the trial We will include participants who completed all study procedures but will also attempt to include those who discontinued Brief CBT-CP
Brief CBT-CP is a manualized protocol that includes six 30-minute sessions over the course of 6 weeks Brief CBT-CP session outlines and patient handouts are included in the appendix Session one focuses on foundational pain education and the development of treatment goals Session two emphasizes balanced engagement in physical activity and pleasurable events Session three emphasizes skills training for easily implemented relaxation techniques Sessions four and five focus on recognizing and modifying unhelpful thoughts that negatively impact pain Session six focuses on relapse prevention and independent implementation of CBT-CP skills following treatment Brief CBT-CP will be delivered by a masters-level interventionist either at the medical center or by telephone depending on the preference of the participant
Participants assigned to TAU only will receive standard medical care from their primary care provider including pain medications brief advice eg use of relative rest application of heat or ice other self-care strategies or referral to pain-related adjunctive interventions eg physical therapy as indicated Participants in TAU only will not receive behavioral intervention from the primary care clinic behavioral health provider
We will conduct brief interviews with up to 24 purposefully selected participants ie 12 providers and 12 patients The provider group will include 6 primary care providers and 6 behavioral health providers I providers who staff Veterans Affairs primary care clinics Interview items are based on implementation constructs relevant for early stage intervention development acceptability or agreeableness and satisfaction with treatment components appropriateness or perceived fitcompatibility of the intervention and feasibility or whether the intervention is suitable for use Up to 12 patients who were randomized to Brief CBT-CP will be asked to complete a 30-minute interviews ie telephone or face-to-face depending on participant preference following their 12-week assessment as described in the consent procedures prior to the trial We will include participants who completed all study procedures but will also attempt to include those who discontinued Brief CBT-CP
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 1I21RX002741-01A1 | NIH | None | httpsreporternihgovquickSearch1I21RX002741-01A1 |