Phone CBT Offers Benefits Despite Inability to Prevent Pain

Phone-based cognitive behavioral therapy (CBT) did not prevent the onset of chronic widespread pain in adults at high risk, but it did result in a range of other health benefits, according to a study published online in the Annals of the Rheumatic Diseases.

“Those receiving the active intervention were more likely to perceive their health as having improved and report better quality of life,” researchers wrote, “as well as lower levels of fatigue and psychological distress.”

Because CBT has been shown to help people manage chronic widespread pain, researchers conducted this study to gauge whether it could prevent its onset. Participants in the UK-based trial were considered at high risk of chronic widespread pain and randomized to either usual care or phone CBT. After an initial assessment, phone CBT was delivered over 6 weekly sessions lasting up to 45 minutes each. Booster sessions also occurred at 3 months and 6 months.

Of 996 participants randomized to interventions, 825 completed a questionnaire about pain onset at 12 months and were included in the analysis. Among them, 18% of those who received CBT and 17.5% of those who received usual care reported onset of chronic widespread pain at 12 months, according to the study.

Although results showed no difference in the proportion of participants who developed chronic widespread pain, those who received CBT were more likely than those who received usual care to report improved health, improved distress, lower levels of fatigue, and better quality of life.

“In summary, this trial has shown that a short course of telephone CBT does not prevent the onset of chronic widespread pain in adults assessed as being at high risk. It did however positively change most other health indicators measured, including quality of life, and was highly cost-effective,” researchers wrote. “It demonstrates that a low-cost, short-duration intervention benefits a wider range of people with musculoskeletal symptoms than previously considered.”

—Jolynn Tumolo

Reference

Macfarlane GJ, Beasley M, Scott N, et al. Maintaining musculoskeletal health using a behavioural therapy approach: a population-based randomised controlled trial (the MAmMOTH Study). Ann Rheum Dis. Published online ahead of print February 1, 2020. 

DOI: 10.1136/annrheumdis-2020-219091