The Cooperative Pain Education and Self-management (COPES) study was a randomized, non-inferiority trial comparing Interactive Voice Response (IVR)- and in-person Cognitive Behavioral Therapy (CBT) in veterans with a chronic back pain.
The use of IVR-CBT promoted pain self-management and improved the accessibility of treatment. Chronic pain is one of the leading causes of major disability and is associated with increased reliance on opioid therapy despite poor outcomes (addiction, overdose, and death). Recommended management includes a multi-modal approach that can involve cognitive behavioral therapy (CBT), an intervention with evidence-based benefit in a variety of pain disorders. Need for trained administrators and resources often limit the use of CBT, especially outside of academic and urban medical centers. This study evaluated the use of automated telephone IVR-based CBT therapy compared to traditional CBT in patients with chronic back pain in a randomized, non-inferiority trial. IVR-CBT is a computerized interface that allows patients to use their telephone to: 1) report pain-related symptoms data and adherence to pain coping skill practice and 2) obtain pre-recorded information and personalized therapist feedback. Although CBT has been shown to be effective in reducing pain intensity, in-person CBT requires patients to make frequent office visits. […]