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A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain.
Simons, Laura E; Harrison, Lauren E; Boothroyd, Derek B; Parvathinathan, Gomathy; Van Orden, Amanda R; O'Brien, Shannon F; Schofield, Deborah; Kraindler, Joshua; Shrestha, Rupendra; Vlaeyen, Johan W S; Wicksell, Rikard K.
Afiliación
  • Simons LE; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States.
  • Harrison LE; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States.
  • Boothroyd DB; Quantitative Statistical Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States.
  • Parvathinathan G; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States.
  • Van Orden AR; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States.
  • O'Brien SF; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States.
  • Schofield D; Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia.
  • Kraindler J; Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia.
  • Shrestha R; Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia.
  • Vlaeyen JWS; Research Group Experimental Health Psychology, Maastricht University, Maastricht, Netherlands and Research Group Health Psychology, KU Leuven, Leuven, Belgium.
  • Wicksell RK; Research Group Behavior Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and Pain Clinic, Capio St Goran Hospital, Stockholm, Sweden.
Pain ; 165(1): 177-191, 2024 Jan 01.
Article en En | MEDLINE | ID: mdl-37624900
ABSTRACT: Graded exposure treatment (GET) is a theory-driven pain treatment that aims to improve functioning by exposing patients to activities previously feared and avoided. Combining key elements of GET with acceptance-based exposure, GET Living (GL) was developed for adolescents with chronic pain (GL). Based on robust treatment effects observed in our single-case experimental design pilot trial of GL (NCT01974791), we conducted a 2-arm randomized clinical trial comparing GL with multidisciplinary pain management (MPM) comprised of cognitive behavioral therapy and physical therapy for pain management (NCT03699007). A cohort of 68 youth with chronic musculoskeletal pain (M age 14.2 years; 81% female) were randomized to GL or MPM. Owing to COVID-19 restrictions, 54% of participants received zoom video delivered care. Assessments were collected at baseline, discharge, as well as at 3-month and 6-month follow-up. Primary outcomes were self-reported pain-related fear and avoidance. Secondary outcomes were child functional disability and parent protective responses to child pain. As hypothesized, GL improved in primary and secondary outcomes at 3-month follow-up. Contrary to our superiority hypothesis, there was no significant difference between GL and MPM. Patients reported both GL and MPM (in person and video) as credible and were highly satisfied with the treatment experience. Next steps will involve examining the single-case experimental design data embedded in this trial to facilitate an understanding of individual differences in treatment responses (eg, when effects occurred, what processes changed during treatment within the treatment arm). The current findings support GET Living and MPM for youth with chronic pain.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Cognitivo-Conductual / Dolor Crónico Tipo de estudio: Clinical_trials Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Pain Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Cognitivo-Conductual / Dolor Crónico Tipo de estudio: Clinical_trials Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Pain Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos