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ORIGINAL RESEARCH article
Front. Pain Res.
Sec. Non-Pharmacological Treatment of Pain
Volume 6 - 2025 | doi: 10.3389/fpain.2025.1547540
This article is part of the Research TopicNon-biomedical Perspectives on Pain and its Prevention and Management – Volume IIView all 3 articles
Long-term pain and health economic outcomes in adults receiving multidisciplinary CBT for chronic pain: The role of psychological inflexibility
Provisionally accepted- 1Lund University, Lund, Sweden
- 2Skåne University Hospital, Lund, Sweden
- 3Uppsala University, Uppsala, Uppsala, Sweden
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Little is known about whether the recommended, non-pharmacological treatments for chronic pain yield reductions in healthcare utilization, social costs and increased productivity in actual practice.The primary aim of this study (n = 232) was to conduct secondary analyses of health economic outcomes using data from national registries combined with clinical outcome data from a large pain center in Sweden conducting multidisciplinary treatment based on a cognitive behavioral approach. Specifically, pain-related and health economic outcomes at post-treatment and one, two and three years after discharge were examined. In an exploratory fashion, we also investigated whether sociodemographic characteristics, pain-related variables, and psychological inflexibility, predicted these long-term pain-related and health economic outcomes. We also examined psychological inflexibility as a potential mediator of these outcomes.Moderate sized improvements in pain, pain interference, and depression observed at posttreatment were all maintained at both the 1-and 3-year follow-up. A very similar pattern was observed for health economic outcomes, with post-treatment gains being maintained at followup. Baseline psychological inflexibility predicted long-term pain-related outcomes, but not health economic outcomes. Changes in psychological inflexibility during treatment and followup mediated long-term pain-related outcomes and the total number of health care visits.The present findings add to a small body of literature indicating that the improvements in pain and related difficulties following multidisciplinary, pain-focused, CBT programs persist at least three years following treatment, and these are accompanied by modest improvements in health economic outcomes over the same interval. Psychological inflexibility seems to be predominately associated with long-term clinical outcomes in pain management, and it also appears relevant to the number of health care visits.
Keywords: Chronic Pain, Long-term outcomes, Health economic outcomes, Psychological inflexibility, Mediator, predictor
Received: 18 Dec 2024; Accepted: 25 Mar 2025.
Copyright: © 2025 Åkerblom, McCracken, Rivano Fischer and Perrin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sophia Åkerblom, Lund University, Lund, Sweden
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