Background: Chronic pain tends to be difficult to manage because of its complex natural history and poor response to therapy. Recently, it has been reported that telecare management by nurses improved outcomes of patients with chronic pain.
Objectives: The aim of this study was to investigate the effect of a telephone consultation approach partially based on a cognitive-behavioral approach on pain and quality of life (QOL) in patients with chronic pain in Japan.
Patients and methods: Telephonic consultation was provided by nurse care managers for the management of pain. They informed the patients how to correct or eliminate excessive fear of pain, improper thinking for treating pain, as well as how to control activity levels by appropriate pacing. We received 463 consultations about chronic pain; however, 153 patients allowed us to recall for follow-up assessment. Finally, we could evaluate the pain intensity for 121 patients and the EuroQOL 5 dimension (EQ-5D) for 37 patients at the initial call and on their condition at 3 to 6 months after that. Wilcoxon signed-rank test and Cohens'd were used for both analyses. We also asked them to rate, by feeling, marked signs of improvement, some improvement, no improvement, or deterioration in pain and QOL, depending on their condition 3 to 6 months after the initial call (n = 121).
Results: The pain intensities were significantly decreased from 7.6 ± 2.0 at baseline to 5.7 ± 2.9 on follow-ups assessed by a numerical rating scale (range; 0 - 10, P < 0.001, effect size (ES); 0.76). The EuroQOL 5 dimension scores were also significantly improved after telephone intervention; 0.5 ± 0.2 to 0.6 ± 0.2 (range; 0 - 1, P < 0.001, ES; 0.65). Moreover, as a result of the consultation, approximately half of the participants felt an improvement in the intensity of pain and QOL.
Conclusions: Telephone consultation partially based on a cognitive-behavioral approach significantly reduced the intensity of pain and improved the QOL in patients with chronic pain in Japan.
Keywords: Chronic Pain; Cognitive Therapy; Nurse Practitioner; Telephone.