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European Spine Journal
Published in: European Spine Journal 7/2012

Open Access 01-07-2012 | Original Article

A short, intensive cognitive behavioral pain management program reduces health-care use in patients with chronic low back pain

Two-year follow-up results of a prospective cohort

Authors: Miranda L. van Hooff, Werner ter Avest, Philip P. Horsting, John O’Dowd, Marinus de Kleuver, Wim van Lankveld, Jacques van Limbeek

Published in: European Spine Journal | Issue 7/2012

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Abstract

Purpose

Cognitive behavioral interventions are recommended as non-invasive treatment options for patients with chronic low back pain (CLBP). However, most treatment effects are small and short-lived. Although a 2-week intensive pain management program for patients with CLBP seems to be effective, the long-term results are not known. The purpose of this study is to evaluate the stability of the 2-year follow-up results and whether this is reflected in the use of health-care services.

Methods

A prospective cohort study was performed. Pre-treatment characteristics of patients and data of outcomes obtained at 1-year follow-up were used. At 2-year follow-up a structured interview was conducted following the principles of a post-marketing survey. Outcomes included daily functioning, quality of life, current intensity of pain, disturbance of pain during daily activities, and indicators of the use of pain medication and health-care services.

Results

Of the 90 eligible patients 85 (94%) participated in the post-marketing survey. The 1-year clinical relevant effects are maintained at 2-year follow-up. Effect sizes for functioning and quality of life were large. More than 65% reached preset minimal clinically important differences. At pre-treatment all patients consulted their general practitioner (GP) and medical specialist (MS). At 2-year follow-up 73% reported having consulted neither a GP nor an MS during the previous year. Most of the patients indicated not to use any pain medication (57%) and the percentage patients using opioids have decreased (14%). Moreover, 81% reported to be at work.

Conclusions

The gained results from selected and motivated patients with longstanding CLBP at 1-year follow-up are stable at 2-year follow-up. Above all, most of the participants are at work and results indicate that the use of both pain medication and health care have decreased substantially.
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Metadata
Title
A short, intensive cognitive behavioral pain management program reduces health-care use in patients with chronic low back pain
Two-year follow-up results of a prospective cohort
Authors
Miranda L. van Hooff
Werner ter Avest
Philip P. Horsting
John O’Dowd
Marinus de Kleuver
Wim van Lankveld
Jacques van Limbeek
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 7/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-011-2091-0

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