Back to Search
Start Over
Acceptance and Commitment Therapy for Prevention of Chronic Postsurgical Pain and Opioid Use in At-Risk Veterans: A Pilot Randomized Controlled Study
- Source :
- The journal of pain. 19(10)
- Publication Year :
- 2018
-
Abstract
- High levels of pain, significant anxiety, or depressive symptoms before surgery put patients at elevated risk for chronic pain and prolonged opioid use following surgery. The purpose of this preliminary study was to assess the efficacy of a 1-day Acceptance and Commitment Therapy (ACT) workshop in “at-risk” veterans for the prevention of chronic pain and opioid use following orthopedic surgery. In a randomized controlled trial, 88 at-risk veterans undergoing orthopedic surgery were assigned to treatment as usual (TAU; n = 44) or TAU plus a 1-day ACT workshop (n = 44). Pain levels and opioid use were assessed up to 3 months following surgery. Pain acceptance and values-based behavior were assessed at baseline and 3-month follow-up. Participants who completed the ACT workshop reached pain and opioid cessation sooner than those in TAU. Postoperative complications exhibited a moderating effect on these outcomes, such that the effects of ACT were greater in patients without complications. Increases in pain acceptance and values-based behavior, processes targeted in ACT, were related to better outcomes. These promising results merit further investigation in a larger clinical trial. Providing an intervention before surgery for at-risk veterans has the potential to change clinical practice from a focus on management of postoperative pain to prevention of chronic pain in at-risk individuals. Perspective This pilot study compared the effects of a 1-day preventive behavioral intervention (ACT) to TAU in at-risk veterans undergoing orthopedic surgery. Three months following the intervention, veterans receiving ACT exhibited quicker cessation of pain and opioid use. Focusing on preoperative pain management may help prevent chronic postsurgical pain.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pilot Projects
Acceptance and commitment therapy
Article
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
030202 anesthesiology
law
medicine
Humans
Pain Management
Single-Blind Method
Acceptance and Commitment Therapy
Depression (differential diagnoses)
Aged
Veterans
Aged, 80 and over
Pain, Postoperative
business.industry
Chronic pain
Middle Aged
medicine.disease
Opioid-Related Disorders
Clinical trial
Analgesics, Opioid
Anesthesiology and Pain Medicine
Treatment Outcome
Neurology
Opioid
Orthopedic surgery
Physical therapy
Anxiety
Female
Neurology (clinical)
medicine.symptom
Chronic Pain
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 15288447
- Volume :
- 19
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The journal of pain
- Accession number :
- edsair.doi.dedup.....f6343a275f4da1835082ab33145950a8