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Internet Cognitive-Behavioral Therapy for Painful Chronic Pancreatitis: A Pilot Feasibility Randomized Controlled Trial
- Source :
- Clinical and Translational Gastroenterology
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Introduction Severe abdominal pain is a cardinal symptom of chronic pancreatitis (CP) associated with a high economic and societal burden. In other chronic pain conditions, cognitive-behavioral therapy (CBT) has demonstrated efficacy in improving patient outcomes (e.g., pain-related disability and depression). However, CBT has not yet been evaluated in adult patients with painful CP. We aimed to (i) evaluate the feasibility and acceptability of an adapted Internet CBT program for CP and (ii) generate pilot data regarding the effects of treatment on patient pain outcomes. Methods Thirty adults (mean age = 49.8 years, SD = 12.5; 80% women) with suspected or definite CP were randomized to Internet CBT (Pancreatitis Pain Course) versus control. The Pancreatitis Pain Course has 5 CBT lessons (e.g., thought challenging, relaxation, and activity pacing) delivered over 8 weeks. Pain interference, pain intensity, and quality of life were assessed at pretreatment, posttreatment, and the 3-month follow-up. Qualitative interviews were conducted at posttreatment with a subset of participants. Results Eighty percent of participants rated the program as highly acceptable; 64.3% completed all 5 lessons. Qualitative data revealed positive perceptions of program features, relevancy, and skills. Patients randomized to Internet CBT demonstrated moderate to large effects in reducing pain intensity and pain interference from baseline to 3 months. The proportion of treatment responders (>30% improvement) was significantly greater in the Internet-CBT group than in the control group (50% vs 13%, Fisher exact t test P = 0.04). Discussion In this first trial of CBT pain self-management in CP, feasibility, acceptability, and preliminary efficacy for reducing pain and disability were demonstrated. Future definitive trials of CBT are needed.
- Subjects :
- medicine.medical_specialty
Abdominal pain
medicine.medical_treatment
behavioral disciplines and activities
Article
law.invention
03 medical and health sciences
symbols.namesake
0302 clinical medicine
Randomized controlled trial
Quality of life
law
medicine
Pancreas
Depression (differential diagnoses)
Fisher's exact test
business.industry
Gastroenterology
Chronic pain
medicine.disease
Cognitive behavioral therapy
030220 oncology & carcinogenesis
Physical therapy
symbols
Pancreatitis
030211 gastroenterology & hepatology
medicine.symptom
business
Subjects
Details
- ISSN :
- 2155384X
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Clinical and Translational Gastroenterology
- Accession number :
- edsair.doi.dedup.....5dcebdb294738cc7e2a34f99a55f03fe