Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial
BackgroundCognitive behavioral therapy is known to improve the management of chronic pain. However, the components of this therapy are still being investigated and debated. ObjectiveThis study aimed to examine the effectiveness of an integrated cognitive behaviora...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2021-11-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2021/11/e30690 |
| _version_ | 1797735533223346176 |
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| author | Kayoko Taguchi Noriko Numata Rieko Takanashi Ryo Takemura Tokiko Yoshida Kana Kutsuzawa Kensuke Yoshimura Natsuko Nozaki-Taguchi Seiji Ohtori Eiji Shimizu |
| author_facet | Kayoko Taguchi Noriko Numata Rieko Takanashi Ryo Takemura Tokiko Yoshida Kana Kutsuzawa Kensuke Yoshimura Natsuko Nozaki-Taguchi Seiji Ohtori Eiji Shimizu |
| author_sort | Kayoko Taguchi |
| collection | DOAJ |
| description |
BackgroundCognitive behavioral therapy is known to improve the management of chronic pain. However, the components of this therapy are still being investigated and debated.
ObjectiveThis study aimed to examine the effectiveness of an integrated cognitive behavioral therapy program with new components (attention-shift, memory work, video feedback, and image training) delivered via videoconferencing.
MethodsThis study was unblinded and participants were recruited and assessed face-to-face in the outpatient department. We conducted a randomized controlled trial for chronic pain to compare 16 weekly videoconference-based cognitive behavioral therapy (vCBT) sessions provided by a therapist with treatment as usual (TAU). Thirty patients (age range, 22-75 years) with chronic pain were randomly assigned to either vCBT (n=15) or TAU (n=15). Patients were evaluated at week 1 (baseline), week 8 (midintervention), and week 16 (postintervention). The primary outcome was the change in pain intensity, which was recorded using the numerical rating scale at 16 weeks from the baseline. Secondary outcomes were pain severity and pain interference, which were assessed using the Brief Pain Inventory. Additionally, we evaluated disability, pain catastrophizing cognition, depression, anxiety, quality of life, and cost utility.
ResultsIn the eligibility assessment, 30 patients were eventually randomized and enrolled; finally, 15 patients in the vCBT and 14 patients in the TAU group were analyzed. Although no significant difference was found between the 2 groups in terms of changes in pain intensity by the numerical rating scale scores at week 16 from baseline (P=.36), there was a significant improvement in the comprehensive evaluation of pain by total score of Brief Pain Inventory (–1.43, 95% CI –2.49 to –0.37, df=24; P=.01). Further, significant improvement was seen in pain interference by using the Brief Pain Inventory (–9.42, 95% CI –14.47 to –4.36, df=25; P=.001) and in disability by using the Pain Disability Assessment Scale (–1.95, 95% CI –3.33 to –0.56, df=24; P=.008) compared with TAU. As for the Medical Economic Evaluation, the incremental cost-effectiveness ratio for 1 year was estimated at 2.9 million yen (about US $25,000) per quality-adjusted life year gained.
ConclusionsThe findings of our study suggest that integrated cognitive behavioral therapy delivered by videoconferencing in regular medical care may reduce pain interference but not pain intensity. Further, this treatment method may be cost-effective, although this needs to be further verified using a larger sample size.
Trial RegistrationUniversity Hospital Medical Information Network UMIN000031124; https://tinyurl.com/2pr3xszb |
| first_indexed | 2024-03-12T13:00:26Z |
| format | Article |
| id | doaj.art-6b303e69fcc441808360718963e114c1 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T13:00:26Z |
| publishDate | 2021-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-6b303e69fcc441808360718963e114c12023-08-28T19:49:19ZengJMIR PublicationsJournal of Medical Internet Research1438-88712021-11-012311e3069010.2196/30690Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled TrialKayoko Taguchihttps://orcid.org/0000-0003-3077-7200Noriko Numatahttps://orcid.org/0000-0003-0117-7740Rieko Takanashihttps://orcid.org/0000-0002-6067-7983Ryo Takemurahttps://orcid.org/0000-0002-3733-7411Tokiko Yoshidahttps://orcid.org/0000-0002-4410-7163Kana Kutsuzawahttps://orcid.org/0000-0003-3142-1281Kensuke Yoshimurahttps://orcid.org/0000-0002-1039-9700Natsuko Nozaki-Taguchihttps://orcid.org/0000-0001-7855-6138Seiji Ohtorihttps://orcid.org/0000-0001-5738-6184Eiji Shimizuhttps://orcid.org/0000-0002-6741-9338 BackgroundCognitive behavioral therapy is known to improve the management of chronic pain. However, the components of this therapy are still being investigated and debated. ObjectiveThis study aimed to examine the effectiveness of an integrated cognitive behavioral therapy program with new components (attention-shift, memory work, video feedback, and image training) delivered via videoconferencing. MethodsThis study was unblinded and participants were recruited and assessed face-to-face in the outpatient department. We conducted a randomized controlled trial for chronic pain to compare 16 weekly videoconference-based cognitive behavioral therapy (vCBT) sessions provided by a therapist with treatment as usual (TAU). Thirty patients (age range, 22-75 years) with chronic pain were randomly assigned to either vCBT (n=15) or TAU (n=15). Patients were evaluated at week 1 (baseline), week 8 (midintervention), and week 16 (postintervention). The primary outcome was the change in pain intensity, which was recorded using the numerical rating scale at 16 weeks from the baseline. Secondary outcomes were pain severity and pain interference, which were assessed using the Brief Pain Inventory. Additionally, we evaluated disability, pain catastrophizing cognition, depression, anxiety, quality of life, and cost utility. ResultsIn the eligibility assessment, 30 patients were eventually randomized and enrolled; finally, 15 patients in the vCBT and 14 patients in the TAU group were analyzed. Although no significant difference was found between the 2 groups in terms of changes in pain intensity by the numerical rating scale scores at week 16 from baseline (P=.36), there was a significant improvement in the comprehensive evaluation of pain by total score of Brief Pain Inventory (–1.43, 95% CI –2.49 to –0.37, df=24; P=.01). Further, significant improvement was seen in pain interference by using the Brief Pain Inventory (–9.42, 95% CI –14.47 to –4.36, df=25; P=.001) and in disability by using the Pain Disability Assessment Scale (–1.95, 95% CI –3.33 to –0.56, df=24; P=.008) compared with TAU. As for the Medical Economic Evaluation, the incremental cost-effectiveness ratio for 1 year was estimated at 2.9 million yen (about US $25,000) per quality-adjusted life year gained. ConclusionsThe findings of our study suggest that integrated cognitive behavioral therapy delivered by videoconferencing in regular medical care may reduce pain interference but not pain intensity. Further, this treatment method may be cost-effective, although this needs to be further verified using a larger sample size. Trial RegistrationUniversity Hospital Medical Information Network UMIN000031124; https://tinyurl.com/2pr3xszbhttps://www.jmir.org/2021/11/e30690 |
| spellingShingle | Kayoko Taguchi Noriko Numata Rieko Takanashi Ryo Takemura Tokiko Yoshida Kana Kutsuzawa Kensuke Yoshimura Natsuko Nozaki-Taguchi Seiji Ohtori Eiji Shimizu Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial Journal of Medical Internet Research |
| title | Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial |
| title_full | Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial |
| title_fullStr | Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial |
| title_full_unstemmed | Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial |
| title_short | Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial |
| title_sort | clinical effectiveness and cost effectiveness of videoconference based integrated cognitive behavioral therapy for chronic pain randomized controlled trial |
| url | https://www.jmir.org/2021/11/e30690 |
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