Chronic Pain Treatment using TIVR

Overview:

This research study is exploring a novel telephone- and computer-based technology for management of chronic pain after the completion of cognitive behavioral group therapy (CBT). The TIVR is being used to augment and maintain the use of pain coping skills taught during CBT groups in order to prevent relapse into pain behavior.

Methods: RECRUITMENT OPEN

At the completion of our 11-week Management of Chronic Pain Program, patients with persistent musculoskeletal pain are consented, assessed for eligibility, and then randomized to one of three study conditions: 1) (treatment condition) pain coping skills training (group CBT) plus 4 months of TIVR maintenance enhancement with minimal monthly feedback; 2) (treatment condition) pain coping skills training (group CBT) plus 4 months of TIVR maintenance enhancement with detailed monthly feedback; or 3) (control condition) pain coping skills training (group CBT) plus treatment as usual without TIVR.

The TIVR maintenance enhancement has four components:

1. Daily Self Monitoring Questionnaire.
2. Didactic Review of Skills.
3. Guided Behavioral Rehearsal of Pain Coping Skills (Practice Sessions).
4. Monthly Therapist Feedback Message.

Research participants assigned to the TIVR treatment conditions are asked to call the automated telephone system (IVR) daily for 4 months.  A comprehensive set of measures are collected during evaluation sessions, carried out before and after pain coping skills training, and at 4-months, 8-months and 12-months post CBT.

Goals:

Chronic pain is a common and seriously debilitating condition both physically and psychologically.  There is considerable evidence that a course of 8-12 weekly behaviorally-oriented group therapy offers significant therapeutic benefit to patients with chronic pain.

However, maintenance of coping skills after the CBT program has finished is variable and patients may experience a decline in the therapeutic benefit within a few weeks.

Our recently completed NIH/NIADA sponsored study confirmed our hypothesis that TIVR enhances the therapeutic effect of group CBT and prevents relapse into pain behavior. The primary objective of the present study is to confirm those results on a larger scale.

We are proud of our low-cost therapeutic intervention which can be accessed by patients remotely. The long-term objective is to create a tool that patients with chronic pain can use by the telephone, independent of group therapy.

Funding:

This study is funded by an RO1 grant from NIH/NIAMS awarded toMagdalena Naylor, M.D., Ph.D., Principal Investigator.