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Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial.

Publication ,  Journal Article
Broderick, JE; Keefe, FJ; Bruckenthal, P; Junghaenel, DU; Schneider, S; Schwartz, JE; Kaell, AT; Caldwell, DS; McKee, D; Reed, S; Gould, E
Published in: Pain
September 2014

A multisite, randomized, controlled clinical effectiveness trial was conducted for osteoarthritis patients with chronic pain of the knee or hip. Adult health nurse practitioners provided a 10-session intervention, pain coping skills training (PCST), in patients' doctors' offices (N=129 patients); the control group received usual care (N=127 patients). Primary outcomes assessed at baseline, posttreatment, 6-month follow-up, and 12-month follow-up were: pain intensity, physical functioning, psychological distress, self-efficacy, catastrophizing, use of coping strategies, and quality of life. Secondary measures included fatigue, social functioning, health satisfaction, and use of pain medication. Methods favoring external validity, consistent with pragmatic, effectiveness research, were utilized. Primary ITT and secondary per-protocol analyses were conducted. Attrition was within the expected range: 11% at posttreatment and 29% at 12-month follow-up; rates did not differ between groups. Omnibus ITT analyses across all assessment points indicated significant improvement for the PCST group compared with the control group for pain intensity, physical functioning, psychological distress, use of pain coping strategies, and self-efficacy, as well as fatigue, satisfaction with health, and reduced use of pain medication. Treatment effects were robust to covariates (demographics and clinical sites). Trends in the outcomes across the assessments were examined. All outcomes, except for self-efficacy, were maintained through the 12-month follow-up; effects for self-efficacy degraded over time. Per-protocol analyses did not yield greater effect sizes. Comparisons of PCST patients who were more vs less treatment adherent suggested greater effectiveness for patients with high adherence. Results support the effectiveness of nurse practitioner delivery of PCST for chronic osteoarthritis pain.

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Published In

Pain

DOI

EISSN

1872-6623

Publication Date

September 2014

Volume

155

Issue

9

Start / End Page

1743 / 1754

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Quality of Life
  • Pain Measurement
  • Osteoarthritis
  • Nurse Practitioners
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
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ICMJE
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Broderick, J. E., Keefe, F. J., Bruckenthal, P., Junghaenel, D. U., Schneider, S., Schwartz, J. E., … Gould, E. (2014). Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial. Pain, 155(9), 1743–1754. https://doi.org/10.1016/j.pain.2014.05.024
Broderick, Joan E., Francis J. Keefe, Patricia Bruckenthal, Doerte U. Junghaenel, Stefan Schneider, Joseph E. Schwartz, Alan T. Kaell, et al. “Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial.Pain 155, no. 9 (September 2014): 1743–54. https://doi.org/10.1016/j.pain.2014.05.024.
Broderick JE, Keefe FJ, Bruckenthal P, Junghaenel DU, Schneider S, Schwartz JE, et al. Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial. Pain. 2014 Sep;155(9):1743–54.
Broderick, Joan E., et al. “Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial.Pain, vol. 155, no. 9, Sept. 2014, pp. 1743–54. Pubmed, doi:10.1016/j.pain.2014.05.024.
Broderick JE, Keefe FJ, Bruckenthal P, Junghaenel DU, Schneider S, Schwartz JE, Kaell AT, Caldwell DS, McKee D, Reed S, Gould E. Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial. Pain. 2014 Sep;155(9):1743–1754.

Published In

Pain

DOI

EISSN

1872-6623

Publication Date

September 2014

Volume

155

Issue

9

Start / End Page

1743 / 1754

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Quality of Life
  • Pain Measurement
  • Osteoarthritis
  • Nurse Practitioners
  • Middle Aged
  • Male
  • Humans
  • Female