Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial.
Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial.
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DOI：
10.1111/jgs.12275
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发表时间：
2013-06
影响因子：
6.3
通讯作者：
Von Korff M
中科院分区：
文献类型：
--
作者：
Vitiello MV;McCurry SM;Shortreed SM;Balderson BH;Baker LD;Keefe FJ;Rybarczyk BD;Von Korff M
评估患有骨关节炎（OA）疼痛和失眠的老年人接受疼痛和失眠的认知行为治疗（CBT-PI），认知行为疼痛应对技能干预（CBT-P）和仅接受教育的对照（EOC）在睡眠和疼痛结局方面是否存在差异。随访9个月的双盲、随机分组对照试验。团体健康和华盛顿大学，2009年至2011年。367例患有OA疼痛和失眠的老年人。在参与者的初级保健诊所提供CBT-PI，CBT-P或EOC的六周小组会议。主要结局为失眠严重程度和疼痛严重程度。次要结果是活动图测量的睡眠效率和关节炎症状。CBT-PI降低失眠严重程度（评分范围0 - 28）超过EOC（调整后的平均差异=-1.89，95%置信区间=-2.83至-0.96; P <.001）和CBT-P（调整后的平均差异= − 2.03，95% CI = − 3.01至− 1.04; P <0.001）和改善睡眠效率（评分范围0 - 100）超过EOC（调整后的平均差异= 2.64，95% CI = 0.44 - 4.84; P = 0.02）。CBT-P并没有比EOC更能改善失眠的严重程度，但改善了睡眠效率（校正的平均差异= 2.91，95% CI = 0.85 - 4.97; P = 0.006）。疼痛的严重程度和关节炎症状在三组之间没有差异。对严重基线疼痛参与者的计划分析显示了类似的结果。9个月以上，失眠的CBT对患有OA疼痛和失眠的老年人有效。将失眠的CBT添加到单独用于疼痛的CBT中可以改善结局。J Am Geriatr Soc 2013.
To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive–behavioral therapy for pain and insomnia (CBT-PI), a cognitive–behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes. Double-blind, cluster-randomized controlled trial with 9-month follow-up. Group Health and University of Washington, 2009 to 2011. Three hundred sixty-seven older adults with OA pain and insomnia. Six weekly group sessions of CBT-PI, CBT-P, or EOC delivered in participants’ primary care clinics. Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms. CBT-PI reduced insomnia severity (score range 0–28) more than EOC (adjusted mean difference = −1.89, 95% confidence interval = −2.83 to −0.96; P < .001) and CBT-P (adjusted mean difference = −2.03, 95% CI = −3.01 to −1.04; P < .001) and improved sleep efficiency (score range 0−100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44−4.84; P = .02). CBT-P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85−4.97; P = .006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results. Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes. J Am Geriatr Soc 2013.
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影响因子：
4.7
作者：
McCurry, Susan M.;Von Korff, Michael;Rybarczyk, Bruce D.
通讯作者：
Rybarczyk, Bruce D.
影响因子：
--
作者：
MEENAN, RF;MASON, JH;KAZIS, LE
通讯作者：
KAZIS, LE
DOI：
10.1080/10401230701468099
发表时间：
2007-07-01
期刊：
Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
影响因子：
--
作者：
Blay, Sergio Luis;Andreoli, Sergio Baxter;Gastal, Fabio Leite
通讯作者：
Gastal, Fabio Leite
影响因子：
9.7
作者：
Coleman, Katie;Austin, Brian T.;Wagner, Edward H.
通讯作者：
Wagner, Edward H.
影响因子：
3.7
作者：
McCurry, Susan M.;Logsdon, Rebecca G.;Vitiello, Michael V.
通讯作者：
Vitiello, Michael V.