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15-11-2011 | Article

Telephone CBT helps chronic pain


Arch Intern Med 2011; Advance online publication

Engaging in cognitive behavioural therapy (CBT) over the telephone enables patients with chronic widespread pain to achieve substantial improvements in their symptoms, a UK study has shown.

The brief, telephone intervention resulted in significant and clinically meaningful improvements in self-rated global health. Similar improvements were seen with a simple exercise programme and both the exercise and telephone CBT combined.

Dr John McBeth (Arthritis Research UK Epidemiology Unit, Manchester) and colleagues say the results "provide encouragement that short-term improvement is possible in a substantial proportion of patients with chronic widespread pain".

The study, reported in the Archives of Internal Medicine, included a total of 442 patients with chronic widespread pain according to American College of Rheumatology criteria for fibromyalgia.

Patients in the telephone CBT only group received an initial hour-long assessment, followed by seven weekly sessions lasting 30-45 minutes and then two further sessions at 3 months and 6 months.

Results showed that 30% of these patients reported a positive outcome on a 7-point global self-assessment scale at 6 months, a rate that was maintained at 9 months. This compared with just 8% of patients receiving usual treatment at both time points.

Writing in a related editorial, Dr Seth Berkowitz and Dr Mitchell Katz (Los Angeles County Department of Health, California, USA) said they welcome such research that "seeks to minimise use of pharmacotherapy, with its unclear efficacy and attendant consequences, in favour of a regimen that focuses, in a truly patient-centred way, on teaching skills for self-management of symptoms and return to meaningful lives".

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price