Enhancing the Biopsychosocial Approach to Perioperative Care: A Pilot Randomized Trial of the Perioperative Pain Self-management (PePS) Intervention.
Ann Surg
; 275(1): e8-e14, 2022 01 01.
Article
en En
| MEDLINE
| ID: mdl-33351478
ABSTRACT
OBJECTIVE:
The current study aimed to pilot the PePS intervention, based on principles of cognitive behavioral therapy (CBT), to determine feasibility and preliminary efficacy for preventing chronic pain and long-term opioid use. SUMMARY BACKGROUND DATA Surgery can precipitate the development of both chronic pain and long-term opioid use. CBT can reduce distress and improve functioning among patients with chronic pain. Adapting CBT to target acute pain management in the postoperative period may impact longer-term postoperative outcomes.METHODS:
This was a mixed-methods randomized controlled trial in a mixed surgical sample with assignment to standard care or PePS, with primary outcomes at 3-months postsurgery. The sample consisted of rural-dwelling United States Military Veterans.RESULTS:
Logistic regression analyses found a significant effect of PePS on odds of moderate-severe pain (on average over the last week) at 3-months postsurgery, controlling for preoperative moderate-severe pain Adjusted odds ratio = 0.25 (95% CI 0.07-0.95, P < 0.05). At 3-months postsurgery, 15% (6/39) of standard care 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, Pâ=â.08). Changes in depression, anxiety, and pain catastrophizing were not significantly different between arms.CONCLUSIONS:
The findings from this study support the feasibility and preliminary efficacy of the PePS intervention.
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
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Terapia Cognitivo-Conductual
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Atención Perioperativa
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Dolor Crónico
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Manejo del Dolor
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Automanejo
Tipo de estudio:
Observational_studies
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Prognostic_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Surg
Año:
2022
Tipo del documento:
Article