The journal of pain : official journal of the American Pain Society 2016 Nov 9() pii S1526-5900(16)30292-9
The purpose of this randomized non-inferiority trial was to compare video-teleconferencing (VTC) versus in-person (IP) delivery of an 8-week Acceptance and Commitment Therapy (ACT) intervention among veterans with chronic pain (N = 128) at posttreatment and 6-month follow-up. The primary outcome was the pain interference subscale of the Brief Pain Inventory. Secondary outcomes included measures of pain severity, mental and physical health-related quality of life, pain acceptance, activity level, depression, pain-related anxiety, and sleep quality. In intent-to-treat analyses using mixed linear-effects modeling, both groups exhibited significant improvements on primary and secondary outcomes, with the exception of sleep quality. Further, improvements in activity level at 6-month follow-up were significantly greater in the IP group. The non-inferiority hypothesis was supported for the primary outcome and several secondary outcomes. Treatment satisfaction was similar between groups; however, significantly more participants withdrew during treatment in the VTC group compared to the IP group, which was moderated by activity level at baseline. These findings generally suggest that ACT delivered via VTC can be as effective and acceptable as IP delivery for chronic pain. Future studies should examine the optimal delivery of ACT for patients with chronic pain who report low levels of activity. This trial was registered at ClinicalTrials.gov (NCT01055639).
This study suggests that Acceptance and Commitment Therapy for chronic pain can be implemented via video-teleconferencing with comparable reductions in pain interference as in-person delivery. This article contains potentially important information for clinicians using telehealth technology to deliver psychosocial interventions to individuals with chronic pain.