Abstract
This paper examines whether a telephone-based, automated maintenance enhancement program
can help to reduce opioid and nonsteroidal anti-inflamatory drugs (NSAID) analgesic
use in patients with chronic pain. Following 11 weeks of group cognitive-behavioral
therapy (CBT), 51 subjects with chronic musculoskeletal pain were randomized to 1
of 2 study groups. Twenty-six subjects participated in 4 months of a Therapeutic Interactive
Voice Response (TIVR) program in addition to standard follow-up care, while a control
group of 25 subjects received standard follow-up care only. TIVR is an automated,
telephone-based tool developed for the maintenance and enhancement of CBT skills.
Opioid analgesic use decreased in the experimental group in both follow-ups: 4 and
8 months postCBT. In addition, at 8-month follow-up, 21% of the TIVR subjects had
discontinued the use of opioid analgesics, 23% had discontinued NSAIDS, and 10% had
discontinued antidepressant medications. In contrast, the control group showed increases
in opioid and NSAIDS use. Analysis of covariance (ANCOVA) revealed significant between-group
differences in opioid analgesic use at 8-month follow up (P = .004). We have previously demonstrated the efficacy of TIVR to decrease pain and
improve coping; this analysis demonstrates that the use of TIVR may also result in
concurrent reductions in opioid analgesic and NSAID medications use.
Perspective
This article demonstrates that the Therapeutic Interactive Voice Response maintenance
enhancement program can help to reduce opioid analgesic use in patients with chronic
pain. This automated maintenance enhancement program could potentially assist patients
not only to decrease pain and improve coping, but also to diminish the likelihood
of opioid dependence.
Key words
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Article info
Publication history
Published online: July 12, 2010
Accepted:
March 29,
2010
Received in revised form:
March 16,
2010
Received:
September 22,
2009
Footnotes
Supported by grants from the National Institute of Drug Addiction (NIDA)R21 DA016115, the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS)R01 AR052131, and the National Institute on Alcohol Abuse and Alcoholism (NIAAA)R01 014270.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
