Heather Poupore-King, Postdoctoral Faculty Sponsor
Enhancing the Biopsychosocial Approach to Perioperative Care: A Pilot Randomized Trial of the Perioperative Pain Self-Management (PePS) Intervention.
Annals of surgery
2020; Publish Ahead of Print
The current study aimed to pilot the Perioperative Pain Self-management (PePS) intervention, based on principles of CBT, to determine feasibility and preliminary efficacy for preventing chronic pain and long-term opioid use.Surgery can precipitate the development of both chronic pain and long-term opioid use. Cognitive behavioral therapy (CBT) can reduce distress and improve functioning among patients with chronic pain. Adapting CBT to target acute pain management in the post-operative period may impact longer-term post-operative outcomes.This was a mixed-methods randomized controlled trial in a mixed surgical sample with assignment to standard care (SC) or PePS, with primary outcomes at 3-months post-surgery. The sample consisted of rural-dwelling United States Military Veterans.Logistic regression analyses found a significant effect of PePS on odds of moderate-severe pain (on average over the last week) at 3-months post-surgery, controlling for pre-operative moderate-severe pain: Adjusted odds ratio = 0.25 (95% CI: 0.07 - 0.95, p < .05). At 3-months post-surgery, 15% (6/39) of SC participants and 2% (1/45) of PePS participants used opioids in the prior seven days: Adjusted Odds ratio = 0.10 (95% CI: 0.01 - 1.29, p = .08). Changes in depression, anxiety, and pain catastrophizing were not significantly different between arms.The findings from this study support the feasibility and preliminary efficacy of the PePS intervention.
View details for DOI 10.1097/SLA.0000000000004671
View details for PubMedID 33351478