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SHP 08-147 – HSR Study

SHP 08-147
Piloting interactive voice response modules for chronic pain treatment
Robert D. Kerns, PhD
VA Connecticut Healthcare System West Haven Campus, West Haven, CT
West Haven, CT
Funding Period: May 2008 - March 2009
Cognitive behavioral therapy (CBT) has been shown in two meta-analyses to be effective in reducing pain intensity, disability, and affective distress in persons with chronic pain. Although effective, traditional CBT is time-intensive and requires patients to make frequent office visits. An alternative is to improve treatment accessibility and efficiency of treatment provision through the use of electronic methods such as interactive voice response (IVR) technology.

This pilot project was designed to test the feasibility and perceived value of IVR-based CBT intervention materials for the treatment of chronic pain. The project involved adapting traditional CBT materials for use in a IVR-based chronic pain treatment.

The project occurred in two phases. Phase 1 included the revision of materials to support the IVR-based intervention including 1) a patient handbook, 2) a library of IVR-compatible scripts for the presentation of pain treatment topics, and 3) guidelines for providing personalized feedback. Phase 2 included the evaluation of the developed materials by a small group of patients with chronic pain. After the treatment materials were revised, their usability, feasibility and perceived value were tested with a small sample of Veterans with chronic pain.

We assessed understanding of the module contents from a small group of veterans (n = 4) via interview and completion of a short true/false quiz. Most participants answered all of the quiz questions correctly. A majority of participants indicated that the materials were clear. After this initial evaluation, we administered CBT using the newly created treatment materials. Four veterans were enrolled, one dropped out after session 5 and three dropped out prior to beginning treatment. The participant answered 80% of the quiz questions correctly and made all expected IVR daily telephone calls without prompting.

The products and results of this study were used to support a Merit Review application designed to test the efficacy of an IVR-based CBT treatment for chronic pain. Our ultimate goal is to use IVR-based CBT to extend the delivery of high quality, convenient treatment to a greater number of Veterans.

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