Long-term pain and health economic outcomes in adults receiving multidisciplinary CBT for chronic pain.
Perrin, Sean LU
; Åkerblom, Sophia
LU
; Rivano Fischer, Marcelo
LU
and McCracken, Lance
(2024)
European Association of Cognitive and Behavioural Psychotherapy 2024 Conference
- Abstract
- Introduction: The first-line evidence-based treatment for chronic pain is multidisciplinary treatment involving pain-focused CBT. Studies have shown that changes in psychological flexibility (PF) during pain-focused CBT positively mediates
outcomes, even when the treatment does not specifically target PF. While CBT and PF-based treatments for chronic pain yield small to moderate, but clinically meaningful improvements in chronic pain and associated difficulties, less is known
about their impact on healthcare utilization and the social cost of missed work due to illness. The present study aims to address this gap in the literature using pain outcome data from a large multidisciplinary pain clinic in Sweden, combined
with... (More) - Introduction: The first-line evidence-based treatment for chronic pain is multidisciplinary treatment involving pain-focused CBT. Studies have shown that changes in psychological flexibility (PF) during pain-focused CBT positively mediates
outcomes, even when the treatment does not specifically target PF. While CBT and PF-based treatments for chronic pain yield small to moderate, but clinically meaningful improvements in chronic pain and associated difficulties, less is known
about their impact on healthcare utilization and the social cost of missed work due to illness. The present study aims to address this gap in the literature using pain outcome data from a large multidisciplinary pain clinic in Sweden, combined
with healthcare and employment data from national registries. In an exploratory fashion, we also examine the role played by changes in psychological flexibility during treatment on long-term outcomes. Methods: Pain-related and health
economic outcomes at post-treatment and one, two and three years after discharge were examined in 232 consecutive referrals to the Pain Rehabilitation Unit at Skåne University Hospital. In an exploratory fashion, we investigated whether
sociodemographic characteristics, pain-related variables, and psychological inflexibility, predicted and/or mediated long term pain-related and health economic outcomes. Results: Moderate sized improvements in pain, pain interference, and
depression observed at post-treatment were all maintained at both the 1- and 3-year follow-up. A very similar pattern was observed for the health economic outcomes, with gains attained by post-treatment being maintained at follow-up. The largest improvements were found for the total number and costs of healthcare visits, with moderate effect sizes by 1-year follow up and remaining stable at both the 2-year and 3-year follow-ups. Healthcare costs declined by 48% during treatment and by the time of the 3-year follow-up, by 59% relative to the year up to commencement of treatment. There was a slight worsening in sick pay and the costs of sick pay at the 1-year follow-up, with small gains not observed until the 2-year- and 3-year follow-ups. While the decline in the number of days with sick pay and associated costs was in the small range, this nonetheless represented a 39% reduction in the cost attributable to days with sick pay by the time of the 3-year follow-up. Psychological inflexibility predicted and/or mediated both long-term pain-related and health economic outcomes. Conclusions: The present findings add to a small body of literature indicating that the improvements for pain and related difficulties in multimodal, pain-focused CBT programs have a durability of at least three years following treatment. There are also meaningful improvements in health economic outcomes up to three years post-treatment. Reductions in psychological inflexibility appears to be an important treatment process for achieving reductions in impairment from chronic pain and the associated costs of healthcare usage and sick days from work. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/24941805-5d8e-4930-9f5e-7d0c955470c4
- author
- Perrin, Sean
LU
; Åkerblom, Sophia
LU
; Rivano Fischer, Marcelo
LU
and McCracken, Lance
- organization
- publishing date
- 2024-09-05
- type
- Contribution to conference
- publication status
- published
- subject
- keywords
- Chronic Pain, Multidisciplinary treatment, cognitive behavior therapy, psychological flexibility, health economic outcomes, predictor variable, mediation analysis
- conference name
- European Association of Cognitive and Behavioural Psychotherapy 2024 Conference
- conference location
- Belgrade, Serbia
- conference dates
- 2024-09-04 - 2024-09-07
- language
- English
- LU publication?
- yes
- id
- 24941805-5d8e-4930-9f5e-7d0c955470c4
- alternative location
- https://eabct2024.org/programme-schema/
- date added to LUP
- 2026-02-18 11:52:53
- date last changed
- 2026-02-18 15:43:18
@misc{24941805-5d8e-4930-9f5e-7d0c955470c4,
abstract = {{Introduction: The first-line evidence-based treatment for chronic pain is multidisciplinary treatment involving pain-focused CBT. Studies have shown that changes in psychological flexibility (PF) during pain-focused CBT positively mediates<br/>outcomes, even when the treatment does not specifically target PF. While CBT and PF-based treatments for chronic pain yield small to moderate, but clinically meaningful improvements in chronic pain and associated difficulties, less is known<br/>about their impact on healthcare utilization and the social cost of missed work due to illness. The present study aims to address this gap in the literature using pain outcome data from a large multidisciplinary pain clinic in Sweden, combined<br/>with healthcare and employment data from national registries. In an exploratory fashion, we also examine the role played by changes in psychological flexibility during treatment on long-term outcomes. Methods: Pain-related and health<br/>economic outcomes at post-treatment and one, two and three years after discharge were examined in 232 consecutive referrals to the Pain Rehabilitation Unit at Skåne University Hospital. In an exploratory fashion, we investigated whether<br/>sociodemographic characteristics, pain-related variables, and psychological inflexibility, predicted and/or mediated long term pain-related and health economic outcomes. Results: Moderate sized improvements in pain, pain interference, and<br/>depression observed at post-treatment were all maintained at both the 1- and 3-year follow-up. A very similar pattern was observed for the health economic outcomes, with gains attained by post-treatment being maintained at follow-up. The largest improvements were found for the total number and costs of healthcare visits, with moderate effect sizes by 1-year follow up and remaining stable at both the 2-year and 3-year follow-ups. Healthcare costs declined by 48% during treatment and by the time of the 3-year follow-up, by 59% relative to the year up to commencement of treatment. There was a slight worsening in sick pay and the costs of sick pay at the 1-year follow-up, with small gains not observed until the 2-year- and 3-year follow-ups. While the decline in the number of days with sick pay and associated costs was in the small range, this nonetheless represented a 39% reduction in the cost attributable to days with sick pay by the time of the 3-year follow-up. Psychological inflexibility predicted and/or mediated both long-term pain-related and health economic outcomes. Conclusions: The present findings add to a small body of literature indicating that the improvements for pain and related difficulties in multimodal, pain-focused CBT programs have a durability of at least three years following treatment. There are also meaningful improvements in health economic outcomes up to three years post-treatment. Reductions in psychological inflexibility appears to be an important treatment process for achieving reductions in impairment from chronic pain and the associated costs of healthcare usage and sick days from work.}},
author = {{Perrin, Sean and Åkerblom, Sophia and Rivano Fischer, Marcelo and McCracken, Lance}},
keywords = {{Chronic Pain; Multidisciplinary treatment; cognitive behavior therapy; psychological flexibility; health economic outcomes; predictor variable; mediation analysis}},
language = {{eng}},
month = {{09}},
title = {{Long-term pain and health economic outcomes in adults receiving multidisciplinary CBT for chronic pain.}},
url = {{https://lup.lub.lu.se/search/files/242637134/Book_of_Abstracts-EABCT2024.pdf}},
year = {{2024}},
}