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Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial
Open accessAbstract
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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“All outcomes, except for self-efficacy, were maintained at 12-month follow-up while effects on self-efficacy degraded over time”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [84]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Broderick et al. [84] reported significant improvement in self-efficacy (F(3,232) = 10.59, p = 0.001) following a nurse-practitioner delivered intervention for OA patients, however this was not maintained at 12-month follow up (p = 0.158).”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [84]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Psychological functioning was measured using the Beck Depression Inventory (BDI) and Beck Depression Inventory-II (BDI-II) scale [124] in eight studies”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [84]
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“ITT analyses were performed on primary outcomes at baseline, post-treatment, 6 and 12 month follow-up which yielded significant group differences, indicating improvement in pain intensity (F(3,233) = 2.75, p = 0.044), physical functioning (F(3,233) = 3.11, p = 0.027), psychological distress (F(3,233) = 2.83, p = 0.039), use of pain coping strategies (F(3,233) = 4.97, p = 0.002), and self-efficacy”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [84]
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Metadata
- Authors
- Broderick, J. E., Keefe, F. J., Bruckenthal, P., Junghaenel, D. U., Schneider, S., Schwartz, J. E., Kaell, A. T., Caldwell, D. S., McKee, D., Reed, S., & Gould, E.
- Affiliations
- Duke University (US)
- Duke Medical Center (US)
- Stony Brook University (US)
- Corresponding author
- Broderick, Joan E.
- ORCID
- Venue
- Pain
- Published
- 2014-09
- Volume
- 155
- Issue
- 9
- Pages
- 1743-1754
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC4171086
- OpenAlex
- W2042890873
- Cited by
- 118
- References
- 63
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 8 · 2023: 9 · 2022: 7 · 2021: 19 · 2020: 15 · 2019: 9 · 2018: 8 · 2017: 12 · 2016: 10 · 2015: 8 · 2014: 2
- FWCI
- 7.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (AR054626)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- nurse practitioners, pain coping skills training, chronic osteoarthritis, knee osteoarthritis, hip osteoarthritis, chronic pain, pain intensity, physical function, psychological distress, self-efficacy, pain catastrophizing, coping strategies, quality of life, fatigue, analgesic use, medication adherence, primary care delivery
- MeSH terms
- Adaptation, Psychological, Aged, Female, Humans, Male, Middle Aged, Nurse Practitioners, Osteoarthritis, Pain Measurement, Quality of Life, Surveys and Questionnaires, Cognitive Behavioral Therapy, Treatment Outcome, Chronic Pain
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