Co-operative Pain Education and Self-management: Expanding Treatment for Real-world Access (COPES ExTRA)

Project Summary

Cognitive behavioral therapy for chronic pain (CBT-CP) is an evidence-based psychological intervention that is effective for reducing pain and improving function for patients with chronic pain, but numerous barriers exist to face-to-face delivery of this treatment, including travel limitations and the scarcity of trained therapists.  The overall goal of this project is to conduct a pragmatic trial to examine the real-world effectiveness of an interactive voice response (IVR) form of Cognitive behavioral therapy for chronic pain (CBT-CP) called Co-operative Pain Education and Self-management (COPES), versus in-person CBT-CP provided by clinicians.

Principal Investigators

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Alicia Heapy, PhD

Impact and Contribution to PMC3 and Society

This project stands to improve the care of Veterans, and by extension, others, with chronic musculoskeletal pain, by demonstrating the feasibility of a low burden, cost-effective intervention that overcomes many known organizational-, provider-, and patient-level barriers to accessing effective pain self-management interventions.

Details

Institutions:
VA Health Care System, Yale School of Medicine

Institute Providing Oversight:  National Center for Complementary and Integrative Health (NCCIH)

Program Officer:  David Clark (NCCIH)

Project Scientist:  Qi-Ying Liu; (National Institute of Alcohol Abuse and Alcoholism (NIAAA))

ClinicalTrials.gov Identifier:  NCT03469505

Trial Status:  Enrolling

Project Narrative

Little is known about the relative effectiveness of available psychological treatments for chronic pain, which patients are most likely to benefit from specific treatments, and what patient-, provider-, and system-level factors represent barriers to patient engagement, participation and sustained benefit in real-world care settings.

Cognitive behavioral therapy for chronic pain (CBT-CP) is an evidence-based psychological intervention that is effective for reducing pain and improving function for patients with chronic pain. Leveraging technology-based interventions, like interactive voice response (IVR), allows patients to engage in treatment from their home and may improve access to CBT-CP. Prior studies have shown this IVR-based treatment improves pain intensity and pain-related function (including pain-related interference, physical and emotional functioning, sleep quality, and quality of life) – while maintaining the advantages of asynchronous treatment of delivery at the patient’s preferred time and place through a digital media.

The overall goal of this project is to conduct a pragmatic trial to examine the real world effectiveness of an IVR-based form of CBT-CP called Co-operative Pain Education and Self-management (COPES) versus in-person CBT-CP provided by clinicians previously trained through VHA’s evidence based psychotherapy program.