| Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial. | |
MedLine Citation:
|
PMID: 23711168 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for pain and insomnia (CBT-PI), a cognitive-behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes. DESIGN: Double-blind, cluster-randomized controlled trial with 9-month follow-up. SETTING: Group Health and University of Washington, 2009 to 2011. PARTICIPANTS: Three hundred sixty-seven older adults with OA pain and insomnia. INTERVENTIONS: Six weekly group sessions of CBT-PI, CBT-P, or EOC delivered in participants' primary care clinics. MEASUREMENTS: Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms. RESULTS: CBT-PI reduced insomnia severity (score range 0-28) more than EOC (adjusted mean difference = -1.89, 95% confidence interval = -2.83 to -0.96; P < .001) and CBT-P (adjusted mean difference = -2.03, 95% CI = -3.01 to -1.04; P < .001) and improved sleep efficiency (score range 0-100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44-4.84; P = .02). CBT-P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85-4.97; P = .006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results. CONCLUSION: Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes. |
Authors:
|
Michael V Vitiello; Susan M McCurry; Susan M Shortreed; Benjamin H Balderson; Laura D Baker; Francis J Keefe; Bruce D Rybarczyk; Michael Von Korff |
Related Documents
:
|
18976268 - Evaluation of different occlusal splints and counselling in the management of myofascia... 9698948 - The analgesic effect of racemic ketamine in patients with chronic ischemic pain due to ... 19762758 - A comparison of intravenous oxycodone and intravenous morphine in patient-controlled po... 12230608 - Intra-ureteric capsaicin in loin pain haematuria syndrome: efficacy and complications. 21868428 - The relationship between cancer pain and quality of life in patients newly admitted to ... 904018 - Vagotomy for relief of pain in some upper gastrointestinal neoplasms. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2013-05-27 |
Journal Detail:
|
Title: Journal of the American Geriatrics Society Volume: 61 ISSN: 1532-5415 ISO Abbreviation: J Am Geriatr Soc Publication Date: 2013 Jun |
Date Detail:
|
Created Date: 2013-06-18 Completed Date: 2013-09-03 Revised Date: 2013-12-04 |
Medline Journal Info:
|
Nlm Unique ID: 7503062 Medline TA: J Am Geriatr Soc Country: United States |
Other Details:
|
Languages: eng Pagination: 947-56 Citation Subset: IM |
Copyright Information:
|
© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society. |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT01142349 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Arthralgia / diagnosis, etiology, therapy* Cluster Analysis Cognitive Therapy / methods* Double-Blind Method Female Follow-Up Studies Humans Life Style* Male Middle Aged Osteoarthritis / complications, therapy* Pain Measurement Retrospective Studies Sleep Sleep Initiation and Maintenance Disorders / complications, physiopathology, therapy* Time Factors Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
|
R01 AG031126/AG/NIA NIH HHS; R01-AG031126/AG/NIA NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Pretransplant Immediately Early-1-Specific T Cell Responses Provide Protection For CMV Infection Aft...
Next Document: How technology is empowering patients? A literature review.