Cognitive Behavior Therapy & Exercise for Chronic Widespread Pain
A study published in the Archives of Internal Medicine evaluated the clinical impact of telephone-delivered cognitive behavioral therapy (TCBT), exercise, or a combined intervention in primary care patients with chronic widespread pain (CWP).
442 patients with CWP (American College of Rheumatology criteria) were randomized to receive 6 months of TCBT, graded exercise, combined intervention, or treatment as usual (TAU). The primary outcome, using a 7-point patient global assessment scale of change in health since trial enrollment (range: very much worse to very much better), was assessed at baseline and 6 months (intervention end) and 9 months after randomization. A positive outcome was defined as “much better” or “very much better.”
At 6 and 9 months, combined intervention was associated with improvements in the 36-Item Short Form Health Questionnaire physical component score and a reduction in passive coping strategies. The authors concluded that TCBT was associated with substantial, statistically significant, and sustained improvements in patient global assessment.