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Remote Programs Effective for Chronic Pain, Study Finds

By Jill Pope, Senior Scientific Editor

A new study led by CHR Distinguished Investigator Lynn DeBar, PhD, and published in JAMA reports that remotely delivered cognitive-behavioral therapy (CBT) was effective in reducing patients’ chronic pain compared to patients receiving usual care. The study was conducted at the Kaiser Permanente Center for Health Research, in partnership with the Kaiser Permanente Washington Health Research Institute.

Cognitive behavioral therapy (CBT) is an effective non-drug treatment for chronic pain. CBT for chronic pain encourages people to identify and challenge thoughts that can make pain worse and offers coping strategies to help people better manage their pain.

The RESOLVE randomized clinical trial compared two modes of remotely delivering CBT services to address patients’ chronic pain. One was a health coach led approach provided through 1:1 phone or video sessions. The other was a self-completed online program (painTRAINER). Both 8-session programs aimed to improve pain and functioning for patients with “high-impact chronic pain” – meaning pain lasting for three months or longer and that impacts life or work activities. The study compared the effectiveness of both remote programs to each other and to usual care.

Researchers conducted the study among patients meeting criteria for high-impact chronic pain at four health care systems: Essentia Health, serving parts of Minnesota, North Dakota, and Wisconsin, and three Kaiser Permanente health care systems: Georgia, Northwest, and Washington. In total, 2,331 patients—44% from rural or medically underserved regions of the U.S.—were randomly assigned to one of the three study arms.

CBT delivered by both remote formats resulted in a 30% or greater improvement in pain severity after treatment (at 3 months) compared with usual care, and a larger effect was seen for those in the health coach group. Both CBT approaches showed similar sustained benefit through 12 months of follow-up compared to those receiving usual care services only.

The new findings demonstrate that remotely delivered CBT is effective for treating adult patients with high-impact chronic pain. Lynn DeBar, PhD, the study’s Principal Investigator, expressed hope that this research will lead to more patients getting treatment: “Given the lack of available services and cost barriers for many struggling with chronic pain, we hope the study encourages widespread adoption of these potentially more accessible and low-cost options.”