Comparing Cognitive Behavioral Therapy and Acupuncture for Managing Chronic Pain (COMBAT Pain)
Project Summary
The COMBAT Pain Trial examines whether adding brief cognitive and behavioral interventions for chronic pain to acupuncture improves engagement, functioning, and pain outcomes for military members, retirees and their families who are seen in primary care settings.
Does combining acupuncture with Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) in military primary care settings increase the exposure to effective treatment and imporove the functioning of those who are experiencing chronic pain?
Although we know that acupuncture and CBT for chronic pain are effective, we do not know the whether combining these treatments improves functioning among those with chronic pain and whether these treatment can be effectively combined within the context of a primary care clinic.
Co-Principal Investigators
COL (Ret.) Paul Crawford, MD
CAPT (Ret.) Jeffrey Goodie, Ph.D., ABPP
Don McGeary, Ph.D., ABPP
Impact and Contribution to PMC and Society
The present study is the first large-scale trial examining the combination of acupuncture and cognitive behavioral therapy for chronic pain. Outcomes from this trial will inform Defense Health Agency pain management policy and will contribute to knowledge regarding primary care-based interventions for nonpharmacologic chronic pain management.
Details
Institutions: Uniformed Services University, Bethesda, MD, University of Texas Health Science Center, San Antonio, TX
Institute Providing Oversight: Uniformed Services University
For an overview, visit clinicaltrials.gov
For results go to publications and search for COMBAT Pain Trial
Project Narrative
The research team will use a randomized, pragmatic trial comparing acupuncture (ACU) to acupuncture with cognitive behavioral therapy for chronic pain (ACU+CBT-CP) at multiple DoD treatment facilities in primary care.
Aim 1: Examine care utilization, pain self-report outcomes, and satisfaction of participants and providers in the two groups.
Hypothesis A: Using electronic health record analysis, those receiving the ACU+CBT-CP will return for fewer acupuncture appointments and will have more time between their 4 acupuncture treatments and their next treatment.
Hypothesis B: Using electronic health record analysis, those receiving the ACU_CBT-CP will demonstrate the fewest number primary care and emergency room visits and reduced use of opioid medication compared to those receiving ACU.
Hypothesis C: Compared with ACU participants, those ACU+CBT-CP will demonstrate significantly improved functional outcomes in critical domains (physical disability, activity engagement, fear of activity, pain acceptance, and self-reported sleep quality). The primary outcome measure will be changes in daily pain ratings.
Hypothesis D: using standardized survey measures, patients who participate in the ACU_CBT-CP will report significantly better satisfaction and other patient reported outcomes ACU.
Any opinions and assertions contained herein are those of the authors and do not reflect those of the Uniformed Services University of the Health Sciences or the Department of Defense.
