Journal article
Enhancing the Biopsychosocial Approach to Perioperative Care: A Pilot Randomized Trial of the Perioperative Pain Self-management (PePS) Intervention
Annals of surgery, Vol.275(1), pp.e8-E14
01/01/2022
DOI: 10.1097/SLA.0000000000004671
PMID: 33351478
Abstract
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.
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.
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.
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, 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.
Details
- Title: Subtitle
- Enhancing the Biopsychosocial Approach to Perioperative Care: A Pilot Randomized Trial of the Perioperative Pain Self-management (PePS) Intervention
- Creators
- Katherine Hadlandsmyth - University of Iowa, Carver College of Medicine, Department of Anesthesia, Iowa City, IowaMandy Conrad - Stanford University School of Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford, CaliforniaKenda Stewart Steffensmeier - Center for Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IowaJennifer Van Tiem - Center for Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IowaAshlie Obrecht - University of Iowa, College of Education, Department of Psychological and Quantitative Foundations, Iowa City, IowaJoseph J Cullen - University of Iowa, Carver College of Medicine, Department of Surgery, Iowa City, IowaMark W Vander Weg - University of Iowa, College of Public Health, Department of Community and Behavioral Health, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Annals of surgery, Vol.275(1), pp.e8-E14
- DOI
- 10.1097/SLA.0000000000004671
- PMID
- 33351478
- NLM abbreviation
- Ann Surg
- ISSN
- 0003-4932
- eISSN
- 1528-1140
- Language
- English
- Date published
- 01/01/2022
- Academic Unit
- Psychiatry; Psychological and Brain Sciences; Surgery; Radiation Oncology; Anesthesia; Injury Prevention Research Center; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984214959502771
Metrics
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