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Long-term pain and health economic outcomes in adults receiving multidisciplinary CBT for chronic pain : the role of psychological inflexibility

Åkerblom, Sophia LU ; McCracken, Lance M ; Rivano Fischer, Marcelo LU and Perrin, Sean LU orcid (2025) In Frontiers in Pain Research 6.
Abstract

BACKGROUND: Little is known about whether the recommended, non-pharmacological treatments for chronic pain yield reductions in healthcare utilization, social costs and increased productivity in actual practice.

METHODS: The primary aim of this study (
n  = 232) was to conduct secondary analyses of health economic outcomes using data from national registries combined with clinical outcome data from a large pain center in Sweden conducting multidisciplinary treatment based on a cognitive behavioral approach. Specifically, pain-related and health economic outcomes at post-treatment and one, two and three years after discharge were examined. In an exploratory fashion, we also investigated whether sociodemographic characteristics,... (More)

BACKGROUND: Little is known about whether the recommended, non-pharmacological treatments for chronic pain yield reductions in healthcare utilization, social costs and increased productivity in actual practice.

METHODS: The primary aim of this study (
n  = 232) was to conduct secondary analyses of health economic outcomes using data from national registries combined with clinical outcome data from a large pain center in Sweden conducting multidisciplinary treatment based on a cognitive behavioral approach. Specifically, pain-related and health economic outcomes at post-treatment and one, two and three years after discharge were examined. In an exploratory fashion, we also investigated whether sociodemographic characteristics, pain-related variables, and psychological
inflexibility predicted these long-term pain-related and health economic outcomes. We also examined psychological
inflexibility as a potential mediator of these outcomes.

RESULTS: Small and moderate sized improvements in pain, pain interference, and depression observed at post-treatment were mostly maintained at both the 1- and 3-year follow-up. A very similar pattern was observed for health economic outcomes, with 1-year follow-up gains being maintained at long-term follow-up. Baseline psychological
inflexibility predicted long-term pain-related outcomes, but not health economic outcomes. Changes in psychological
inflexibility during treatment and follow-up mediated long-term pain-related outcomes and the total number of health care visits.

CONCLUSIONS: The present findings add to a small body of literature indicating that the improvements in pain and related difficulties following multidisciplinary, pain-focused, CBT programs persist at least three years following treatment, and these are accompanied by modest improvements in health economic outcomes over the same interval. Psychological
inflexibility seems to be predominately associated with long-term clinical outcomes in pain management, and it also appears relevant to the number of health care visits.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic Pain, psychological flexibility, cognitive behavior therapy, health economic outcomes, longitudinal analysis, mediation
in
Frontiers in Pain Research
volume
6
article number
1547540
publisher
Frontiers Media S. A.
external identifiers
  • scopus:105004764123
  • pmid:40356716
ISSN
2673-561X
DOI
10.3389/fpain.2025.1547540
language
English
LU publication?
yes
additional info
© 2025 Åkerblom, McCracken, Rivano Fischer and Perrin.
id
7618daae-ea8e-4207-9a26-447ab33d55d4
date added to LUP
2025-05-19 13:11:43
date last changed
2025-06-17 05:15:17
@article{7618daae-ea8e-4207-9a26-447ab33d55d4,
  abstract     = {{<p>BACKGROUND: Little is known about whether the recommended, non-pharmacological treatments for chronic pain yield reductions in healthcare utilization, social costs and increased productivity in actual practice.</p><p>METHODS: The primary aim of this study (<br>
 n  = 232) was to conduct secondary analyses of health economic outcomes using data from national registries combined with clinical outcome data from a large pain center in Sweden conducting multidisciplinary treatment based on a cognitive behavioral approach. Specifically, pain-related and health economic outcomes at post-treatment and one, two and three years after discharge were examined. In an exploratory fashion, we also investigated whether sociodemographic characteristics, pain-related variables, and psychological <br>
 inflexibility predicted these long-term pain-related and health economic outcomes. We also examined psychological <br>
 inflexibility as a potential mediator of these outcomes.<br>
 </p><p>RESULTS: Small and moderate sized improvements in pain, pain interference, and depression observed at post-treatment were mostly maintained at both the 1- and 3-year follow-up. A very similar pattern was observed for health economic outcomes, with 1-year follow-up gains being maintained at long-term follow-up. Baseline psychological <br>
 inflexibility predicted long-term pain-related outcomes, but not health economic outcomes. Changes in psychological <br>
 inflexibility during treatment and follow-up mediated long-term pain-related outcomes and the total number of health care visits.<br>
 </p><p>CONCLUSIONS: The present findings add to a small body of literature indicating that the improvements in pain and related difficulties following multidisciplinary, pain-focused, CBT programs persist at least three years following treatment, and these are accompanied by modest improvements in health economic outcomes over the same interval. Psychological<br>
 inflexibility seems to be predominately associated with long-term clinical outcomes in pain management, and it also appears relevant to the number of health care visits.<br>
 </p>}},
  author       = {{Åkerblom, Sophia and McCracken, Lance M and Rivano Fischer, Marcelo and Perrin, Sean}},
  issn         = {{2673-561X}},
  keywords     = {{Chronic Pain; psychological flexibility; cognitive behavior therapy; health economic outcomes; longitudinal analysis; mediation}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Pain Research}},
  title        = {{Long-term pain and health economic outcomes in adults receiving multidisciplinary CBT for chronic pain : the role of psychological inflexibility}},
  url          = {{http://dx.doi.org/10.3389/fpain.2025.1547540}},
  doi          = {{10.3389/fpain.2025.1547540}},
  volume       = {{6}},
  year         = {{2025}},
}