Tailored Cognitive-Behavior Therapy for Chronic Pain

针对慢性疼痛的定制认知行为疗法

• 批准号: 6736415
• 负责人: RALPH J COBURN
• 金额: $ 10.7万
• 依托单位: INTERACTIVE PERFORMANCE TECHNOLOGIES
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6736415
• 关键词: backache; behavioral /social science research tag; chronic pain; clinical research; cognitive behavior therapy; computer assisted patient care; computer human interaction; computer system design /evaluation; coping; functional ability; health care service utilization; health services research tag; human subject; human therapy evaluation; medical rehabilitation related tag; motivation; patient care management; patient care personnel relations; patient oriented research; personality; primary care physician; quality of life; rehabilitation; telemedicine; therapy compliance; therapy design /development

DESCRIPTION (provided by applicant): This Phase I research will assess the feasibility of tailored cognitive-behavior therapy, delivered using interactive voice response (IVR) telephone technology, to improve the outcomes of chronic back pain patients. Cognitive-behavior therapy (CBT) has consistently been shown to be an effective treatment for chronic pain. However, not all patients respond uniformly to CBT. Both patient-related and treatment-related factors undermine treatment effectiveness. Efforts to improve treatment participation and adherence have important implications for improving chronic back pain outcomes. Tailoring treatments to patients' psychosocial-behavioral characteristics could significantly enhance the efficiency and effectiveness of CBT. Combining clinically sensitive treatment matching and computer-automated telephone technologies offers the potential to extend more effective CBT to larger populations. In Phase I, we will create and test the usability, acceptance, and potential value of a working TCBT-IVR prototype among physicians and chronic back pain patients. We will use assessments we have developed and IVR software to deliver tailored CBT matched to each patient's stage of readiness to engage in therapy and to their personal preferences for learning, adopting and using specific pain coping skills. We hypothesize that tailored CBT will help chronic back pain patients participate more fully in their treatment by increasing their motivation and helping them learn, practice, and maintain specific pain coping skills that will improve their quality of life and productivity. Patients receiving tailored CBT will also improve treatment adherence and lower treatment refusal and dropout rates. Patients will maintain higher rates of use of adaptive pain coping skills and sustain treatment gains for longer periods of time. Our product goal is an interactive, telephone-based software application that will extend and strengthen the delivery of effective cognitive-behavioral therapy to larger numbers of patients who could benefit. If we are successful in Phase I, we will conduct an efficacy test of TCBT-IVR in Phase II. Our CBT-IVR, if successful, will have significant commercial potential in employer, payer, and provider markets.

描述（由申请人提供）：该第一阶段研究将评估使用交互式语音应答（IVR）电话技术提供的定制认知行为疗法的可行性，以改善慢性背痛患者的治疗结果。认知行为疗法（CBT）一直被证明是治疗慢性疼痛的有效方法。然而，并非所有患者对 CBT 的反应一致。患者相关因素和治疗相关因素都会削弱治疗效果。努力提高治疗参与度和依从性对于改善慢性背痛结果具有重要意义。根据患者的心理社会行为特征定制治疗可以显着提高 CBT 的效率和效果。将临床敏感的治疗匹配和计算机自动电话技术相结合，有可能将更有效的 CBT 扩展到更多人群。 在第一阶段，我们将创建并测试 TCBT-IVR 原型在医生和慢性背痛患者中的可用性、接受度和潜在价值。我们将使用我们开发的评估和 IVR 软件来提供量身定制的 CBT，该 CBT 与每位患者参与治疗的准备阶段以及他们对学习、采用和使用特定疼痛应对技能的个人偏好相匹配。 我们假设，量身定制的 CBT 将帮助慢性背痛患者更充分地参与治疗，提高他们的积极性，帮助他们学习、练习和保持特定的疼痛应对技能，从而提高他们的生活质量和生产力。接受定制 CBT 的患者还将提高治疗依从性并降低治疗拒绝和退出率。患者将保持较高的适应性疼痛应对技能使用率，并在较长时间内维持治疗效果。 我们的产品目标是一种基于电话的交互式软件应用程序，它将扩展和加强有效的认知行为治疗的提供，让更多的患者受益。如果我们一期成功，我们将在二期进行TCBT-IVR的疗效测试。我们的 CBT-IVR 如果成功，将在雇主、付款人和提供商市场中具有巨大的商业潜力。