Evidence map›Paper›PMID 42013134›Full record

Trial reportPain2026

Predictors of patient treatment adherence and moderators of response for a randomized clinical trial comparing remote cognitive behavioral therapy approaches for high-impact chronic musculoskeletal pain.

Andrea J Cook, Robert D Wellman, Meghan Mayhew, Benjamin H Balderson, Morgan Justice, Ashli A Owen-Smith, Francis J Keefe, Christine Rini, Michael Von Korff, Lynn L DeBar

Abstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
In one paragraph

Trial report in Pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Andrea J CookKaiser Permanente Washington Health Research Institute, Seattle, WA, United States.ORCID 0000-0002-6848-5222
Robert D WellmanKaiser Permanente Washington Health Research Institute, Seattle, WA, United States.
Meghan MayhewKaiser Permanente Center for Health Research, Portland, OR, United States.
Benjamin H BaldersonKaiser Permanente Washington Health Research Institute, Seattle, WA, United States.
Morgan JusticeKaiser Permanente Washington Health Research Institute, Seattle, WA, United States.
Ashli A Owen-SmithGeorgia State University and Center for Research and Evaluation Kaiser Permanente Georgia, Atlanta, GA, United States.
Francis J KeefeDuke Pain Prevention and Treatment Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.
Christine RiniDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, United States.
Michael Von KorffKaiser Permanente Washington Health Research Institute, Seattle, WA, United States.
Lynn L DeBarKaiser Permanente Center for Health Research, Portland, OR, United States.

Funding

Tailored Non-Pharmacotherapy Services for Chronic Pain: Testing Scalable and Pragmatic Approaches - Admin SupplementUH3AG067493 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI DEBAR, LYNN L. · 2020 to 2023
$11.9M
Tailored Non-Pharmacotherapy Services for Chronic Pain: Testing Scalable and Pragmatic ApproachesUG3AG067493 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI DEBAR, LYNN L. · 2019 to 2019
$1.3M
NIA NIH HHS UG3 AG067493NIA NIH HHS UH3 AG067493NINDS NIH HHS UG3AG067493/UH3AG067493
6 · The paper itself

Abstract

abstractRemote cognitive behavioral therapy-based interventions for chronic pain (CBT-CP-based) have consistently shown modest pain benefits. With remote treatment availability accelerating and increasingly tight healthcare resources, clinical decision-makers need to understand when working with a therapist may be beneficial vs a largely self-directed online program. Using data from a large-scale 3-arm pragmatic trial, we assessed the role of patient session adherence and potential moderators of intervention pain severity effectiveness for 2 remote CBT-CP-based approaches (online program [painTRAINER] and therapist-delivered telephone or video program [health coach]) and usual medical care. Of the prespecified moderators (demographics [sex, age, race/ethnicity, rurality], social determinants of health, and clinical variables [comorbid depression and/or anxiety, multiple types of chronic pain]), the health coach program was more effective than painTRAINER at 3 months among men and for those who screened positive for depression. No other factors moderated intervention pain severity effects at 3 or 12 months. The health coach program had higher session adherence than painTRAINER (70.4% vs 47.8%). Among intervention completers, pain severity outcomes were similar between CBT-CP-based interventions (Adjusted relative risk [95% confidence interval]: 0.99 [0.85-1.16] and 0.93 [0.82-1.05] at 3 and 12 months, respectively), suggesting that both interventions may be helpful for those with a variety of demographic and clinical characteristics if adherence is achieved. Participant engagement is critical in optimizing outcomes for online programs, but these findings suggest flexibility in the specific modality for delivering remote CBT-CP based on patient preference and healthcare system capacity that may enhance scalability and patient access to care.

Indexed as

Chronic PainCognitive Behavioral TherapyMusculoskeletal PainPatient ComplianceAdultFemaleHumansMaleMiddle AgedPain MeasurementTreatment OutcomeChronic musculoskeletal painModeratorsPatient treatment adherenceRemote cognitive behavioral therapy

Identifiers

PMID42013134
PMCPMC13345604

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.