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Outcomes Associated with a Cognitive-Behavioral Chronic Pain Management Program Implemented in Three Public HIV Primary Care Clinics

Abstract  

In patients with HIV/AIDS, chronic pain is common and analgesics pose serious risks. Cognitive-behavioral therapies (CBT)
provide an alternative. This study evaluated feasibility and impact of a CBT-based pain management program in three public
primary care clinics for HIV patients. The program included a workbook and 12-weeks of group CBT sessions. HIV-positive patients
with chronic moderate to severe pain were invited to participate in the program and were assessed at enrollment, 6, 12, and
24 weeks. Despite only moderate group attendance, program enrollment was associated with significant improvements in pain
intensity, pain-related functioning, anxiety and acceptance, and mental health. At 24 weeks, effect sizes for pain outcomes
were −0.83 for pain intensity and −0.43 for functioning. The pattern of change in outcomes was consistent with predictions
based on cognitive-behavioral theory. Effects were observed at all clinics. Adding CBT-based pain management into primary
care may provide important benefits for patients with HIV/AIDS.

  • Content Type Journal Article
  • Pages 1-16
  • DOI 10.1007/s11414-011-9254-y
  • Authors
    • Jodie A. Trafton, Center for Health Care Evaluation, VA Palo Alto Healthcare System and Stanford University Medical School, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA
    • John T. Sorrell, San Mateo County, San Francisco Peninsula AIDS Research Center and San Mateo County AIDS Program, 222 West 39th Avenue, San Mateo, CA 94403, USA
    • Mark Holodniy, HIV Clinical Program and AIDS Research Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304-1290, USA
    • Heather Pierson, Center for Health Care Evaluation, VA Palo Alto Healthcare System and Stanford University Medical School, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA
    • Percy Link, Center for Health Care Evaluation, VA Palo Alto Healthcare System and Stanford University Medical School, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA
    • Ann Combs, Center for Health Care Evaluation, VA Palo Alto Healthcare System and Stanford University Medical School, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA
    • Dennis Israelski, Division of Infectious Diseases, Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive (Stanford Mail Code: 5107), Stanford, CA 94305, USA
    • Journal The Journal of Behavioral Health Services and Research
    • Online ISSN 1556-3308
    • Print ISSN 1094-3412
Posted in: Journal Article Abstracts on 10/03/2011 | Link to this post on IFP |
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