Group cognitive behavioral therapy to improve the quality of care to opioid-treated patients with chronic noncancer pain: a practice improvement project

Stacey K. Whitten, Julie Stanik-Hutt

Research output: Contribution to journalArticle

Abstract

PURPOSE: To enhance outcomes of patients with chronic noncancer pain (CNCP) treated with opioids in a primary care setting by implementing an evidence-based quality improvement project.

DATA SOURCES: The project consisted of the implementation of a 6-week cognitive behavioral therapy (CBT) program. Twenty-two patients with CNCP completed the program. Impact of the project was evaluated by comparing pre- and postintervention participant self-reports of mood on the Beck Depression Inventory and functional status on the Brief Pain Inventory and Short Form-36. Patient perception of treatment benefit was also measured using the Patient Global Impression of Change. Qualitative provider perceptions of the program were also collected. Paired t-test statistics were used to analyze the data.

CONCLUSIONS: Mood (including negative attitude, performance difficulty, and physical complaints), and patient impression of treatment benefit improved significantly after CBT was added. Primary care providers reported that the CBT supported their overall management of these complex patients.

IMPLICATIONS FOR PRACTICE: The addition of a CBT program improved selected outcomes in this self-selected sample of patients with CNCP treated with opioids.

Original languageEnglish (US)
Pages (from-to)368-376
Number of pages9
JournalJournal of the American Association of Nurse Practitioners
Volume25
Issue number7
DOIs
StatePublished - Jul 1 2013
Externally publishedYes

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Quality of Health Care
Cognitive Therapy
Chronic Pain
Opioid Analgesics
Primary Health Care
Equipment and Supplies
Quality Improvement
Self Report
Depression
Pain
Therapeutics

Keywords

  • cognitive behavioral therapy (CBT)
  • outpatient
  • pain management
  • primary care
  • Quality improvement

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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abstract = "PURPOSE: To enhance outcomes of patients with chronic noncancer pain (CNCP) treated with opioids in a primary care setting by implementing an evidence-based quality improvement project.DATA SOURCES: The project consisted of the implementation of a 6-week cognitive behavioral therapy (CBT) program. Twenty-two patients with CNCP completed the program. Impact of the project was evaluated by comparing pre- and postintervention participant self-reports of mood on the Beck Depression Inventory and functional status on the Brief Pain Inventory and Short Form-36. Patient perception of treatment benefit was also measured using the Patient Global Impression of Change. Qualitative provider perceptions of the program were also collected. Paired t-test statistics were used to analyze the data.CONCLUSIONS: Mood (including negative attitude, performance difficulty, and physical complaints), and patient impression of treatment benefit improved significantly after CBT was added. Primary care providers reported that the CBT supported their overall management of these complex patients.IMPLICATIONS FOR PRACTICE: The addition of a CBT program improved selected outcomes in this self-selected sample of patients with CNCP treated with opioids.",
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