Cognitive behavioral therapy may not benefit trauma patients vs. education alone
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Key takeaways:
- A cognitive behavioral therapy program may not improve outcomes for trauma patients vs. a standard education program.
- The cohorts had similar improvements in physical function scores from baseline to 1 year.
Compared with education alone, telephone-based cognitive behavioral therapy did not significantly improve functional or pain outcomes for patients with traumatic lower extremity injuries, according to published results.
Researchers from the Major Extremity Trauma Research Consortium performed a multicenter, randomized controlled trial of 325 patients (mean age, 36.9 years) who presented to a level-1 trauma center for at least one acute traumatic injury to the lower extremity, pelvis or acetabulum and required operative fixation.
Researchers randomly assigned 165 patients to receive remote cognitive behavioral therapy (CBT) and 160 patients to receive standard education, which was matched to the CBT program for session frequency. Researchers assessed Patient-Reported Outcome Measurement Information System (PROMIS) scores at 6 months and 1 year after the interventions.
Overall, 129 patients in the CBT cohort and 139 patients in the education cohort underwent the full duration of treatment. Researchers found no differences between the cohorts for pain intensity, pain interference, general health and objective physical function.
Researchers also found PROMIS physical function scores were similar between patients in the CBT cohort vs. patients in the education cohort at baseline (30.9 vs. 30.6, respectively), at 6 months (41 vs. 41.4, respectively) and at 1 year (44.6 vs. 44.1, respectively). Mean treatment effect for PROMIS physical function from baseline to 1 year was 0.94.
Despite finding no additional benefit in terms of physical function from CBT for this patient population, researchers wrote CBT had high adherence rates and low costs compared with in-person interventions.
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