Efficacy and Cost-effectiveness of Acceptance and Commitment Therapy and Applied Relaxation for Longstanding Pain: A Randomized Controlled Trial.

Related Articles

Efficacy and Cost-effectiveness of Acceptance and Commitment Therapy and Applied Relaxation for Longstanding Pain: A Randomized Controlled Trial.

Clin J Pain. 2015 Jan 12;

Authors: Kemani MK, Olsson GL, Lekander M, Hesser H, Andersson E, Wicksell RK

Abstract
BACKGROUND AND OBJECTIVES:: To date, few studies have compared Acceptance and Commitment Therapy (ACT) for longstanding pain with established treatments. Only one study has evaluated the cost-effectiveness of ACT. The aim of the current study was to evaluate the efficacy and cost-effectiveness of ACT and applied relaxation (AR) for adults with unspecific longstanding pain.
MATERIALS AND METHODS:: Based on inclusion criteria 60 consecutive patients received 12 weekly group-sessions of ACT or AR. Data was collected pre-, mid- and post-treatment, as well as at 3- and 6-month follow-up. Growth curve modeling was used to analyze treatment effects on pain disability, pain intensity, health-related quality of life (physical domain), anxiety, depression and acceptance.
RESULTS:: Significant improvements were seen across conditions (pre-treatment to follow-up assessment) on all outcome measures. Pain disability decreased significantly in ACT relative to AR from pre- to post-assessment. A corresponding decrease in pain disability was seen in AR between post-assessment and 6-month follow-up. Pain acceptance increased only in ACT, and this effect was maintained at 6-month follow-up. Approximately 20% of the participants achieved clinically significant change following treatment. Health economic analyses showed that ACT was more cost-effective than AR at post- and 3-month follow-up assessment, but not at 6-month follow-up.
DISCUSSION:: More studies investigating moderators and mediators of change are needed. The present study is one of few that have evaluated the cost-effectiveness of ACT and AR and compared ACT with an established behavioral intervention, and the results provide additional support for behavioral interventions for longstanding pain.

PMID: 25585272 [PubMed - as supplied by publisher]