Tailored cognitive-behavioral therapy in early rheumatoid arthritis for patients at risk: a randomized controlled trial
Abstract
Recent developments in chronic pain research suggest that effectiveness of cognitive-behavioral therapy (CBT) may be optimized when applying early, customized treatments to patients at risk. For this purpose, a randomized, controlled trial with tailor-made treatment modules was conducted among patients with relatively early rheumatoid arthritis (RA disease duration of <8 years), who had been screened for psychosocial risk profiles. All participants received standard medical care from a rheumatologist and rheumatology nurse consultant. Patients in the CBT condition additionally received an individual CBT treatment with two out of four possible treatment modules. Choice of treatment modules was determined on the basis of patient priorities, which resulted in most frequent application of the fatigue module, followed by the negative mood, social relationships and pain and functional disability modules. Analyses of completers and of intention-to-treat revealed beneficial effects of CBT on physical, psychological and social functioning. Specifically, fatigue and depression were significantly reduced at post-treatment and at the 6-month follow-up in the CBT condition in comparison to the control condition, while perceived support increased at follow-up assessment. In addition, helplessness decreased at post-treatment and follow-up assessment, active coping with stress increased at post-treatment, and compliance with medication increased at follow-up assessment in the CBT condition i…
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For Evers 2002, treatment expectations was at unclear risk of bias.
“Not assessed”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Evers 2002
For Evers 2002, allocation concealment was at low risk of bias.
“...previously determined pattern of random numbers”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Evers 2002
For Evers 2002, selective reporting was at unclear risk of bias.
“Trial not pre-registered”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Evers 2002
For Evers 2002, incomplete outcome data was at low risk of bias.
“Completer and ITT analyses using LOCF; attrition < 10%”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Evers 2002
A limitation of Evers et al.'s study is that it did not include a group of patients assigned to receive standard cognitive-behavioral therapy against which one could compare the effects of tailored cognitive-behavioral therapy.
“A limitation of this study, however, is that it did not include a group of patients who were assigned to receive standard cognitive-behavioral therapy against which one could compare the effects of tailored cognitive-behavioral therapy.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [22]
In Evers et al.'s study, patients with early rheumatoid arthritis were randomly assigned to either a tailored cognitive-behavioral therapy protocol or standard medical care.
“Patients in this study were randomly assigned to either a tailored cognitive-behavioral therapy protocol or standard medical care.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [22]
In Evers et al.'s study, the tailored cognitive-behavioral therapy group had a number of significant short- and long-term benefits when compared to standard medical care.
“Data analyses showed that that the tailored cognitive-behavioral therapy group had a number of significant short- and long-term benefits when compared to standard medical care.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [22]
In Evers et al.'s study, patients receiving the tailored treatment reported significantly lower levels of fatigue, depression, and helplessness and higher levels of active coping, social support, and compliance with medication.
“Specifically, patients receiving the tailored treatment reported significantly lower levels of fatigue, depression, and helplessness and higher levels of active coping, social support, and compliance with medication.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [22]
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- Authors
- Evers, A. W. M., Kraaimaat, F. W., van Riel, P. L. C. M., & de Jong, A. J. L.
- Affiliations
- Radboud University Medical Center (NL)
- Corresponding author
- Evers, Andrea W.M
- ORCID
- Evers, Andrea W.M
- Venue
- Pain
- Published
- 2002-11
- Volume
- 100
- Issue
- 1
- Pages
- 141-153
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2022537466
- Cited by
- 301
- References
- 7
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 25 · 2023: 5 · 2022: 7 · 2021: 8 · 2020: 10 · 2019: 12 · 2018: 6 · 2017: 9 · 2016: 21 · 2015: 21 · 2014: 8 · 2013: 16 · 2012: 15
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, early rheumatoid arthritis, tailored treatment, psychosocial risks, fatigue, depression, helplessness, stress coping, medication adherence, social functioning, patient priorities, treatment modules
- MeSH terms
- Adult, Arthritis, Rheumatoid, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pain, Patient Dropouts, Psychology, Risk Factors, Social Behavior, Cognitive Behavioral Therapy, Treatment Outcome, Pain Management
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