Tailored Cognitive-Behavior Therapy for Chronic Pain

描述(由申请人提供)：这项第一阶段的研究将评估使用交互式语音应答(IVR)电话技术进行的量身定制认知行为治疗的可行性，以改善慢性背痛患者的结果。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，并不是所有的患者都对CBT有一致的反应。与患者相关和与治疗相关的因素都会破坏治疗效果。提高治疗参与度和依从性的努力对改善慢性背痛的结果具有重要意义。针对患者的心理社会行为特征进行量身定制的治疗可以显著提高CBT的效率和效果。结合临床敏感的治疗匹配和计算机自动电话技术，有可能将更有效的CBT推广到更多的人群。 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，以匹配每个患者参与治疗的准备阶段以及他们在学习、采用和使用特定疼痛应对技能方面的个人偏好。 我们假设，量身定制的CBT将通过增加患者的动力并帮助他们学习、练习和保持特定的疼痛应对技能，从而帮助他们更充分地参与治疗，从而提高他们的生活质量和生产力。接受量身定制CBT的患者还将提高治疗依从性，降低治疗拒绝率和辍学率。患者将保持更高的适应性疼痛应对技能的使用率，并在更长的时间内保持治疗成果。 我们的产品目标是一种交互式的、基于电话的软件应用程序，它将扩展和加强向更多可能受益的患者提供有效的认知行为治疗。如果我们在第一阶段取得成功，我们将在第二阶段进行TCBT-IVR的有效性测试。如果成功，我们的CBT-IVR将在雇主、支付者和提供商市场具有巨大的商业潜力。

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.