CatastrophizationCT_TKANCT01772329
Preoperative Cognitive Therapy for Improving Health Outcomes After TKA in High-risk Catastrophizing Subjects
A study testing Cognitive Therapy and Routine Care in people with Catastrophization, run by Rush University Medical Center at 1 site in United States.
Trial summary
The investigators propose a randomized controlled trial to evaluate the effects of treatment intended to reduce pain catastrophizing among patients reporting high pain catastrophizing prior to total knee replacement(TKR), total hip replacement(THR), or shoulder surgery in an effort to thereby reduce the incidence of… Read more about this study
- Who is it for?
- Ages 18 to 85 yearsHealthy volunteers can take part
- Conditions the study is for
- Catastrophization
- What is being tested?
- Cognitive Therapy and Routine Care
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 160 participants
- Where
- 1 siteUnited States
- Study dates
- Jan 2013to Oct 2020
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 85 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- undergoing standard primary TKR; THR or Shoulder Surgery
- 18- 85 yrs of age;
- Surgical joint is the primary source of patient's pain;
- Patient agrees to preoperative visits and treatment, follow-up visits and treatment, and to comply with the assessment tests;
- Patient consents to standard anesthetic and analgesic protocol, with medical care as deemed necessary by the anesthesiologist, and has no contraindications.
- Patient has been diagnosed with osteoarthritis.
Who cannot join
- Currently using antidepressant medication or undergoing cognitive therapy;
- chronic opioid use ≥ 10 mg/day of morphine equivalents within one wk prior to the surgery, and duration of use > 4 wks;
- history of opioid abuse;
- inability to understand and communicate with the investigators to complete the study related questionnaires
- patient is planning to undergo another elective joint procedure during the 6-mo period of participation;
- any co-morbidity which results in severe systemic disease limiting function {as defined by the American Society of Anesthesiology (ASA) physical status classification > 3}.
Trial locations and contacts
1 site in 1 country.
United States1 site
Rush University Medical Center
Chicago, Illinois, 60612
About this study
Official title: Preoperative Cognitive Therapy for Improving Health Outcomes After Total Knee Replacement in High-risk Catastrophizing Subjects
The investigators propose a randomized controlled trial to evaluate the effects of treatment intended to reduce pain catastrophizing among patients reporting high pain catastrophizing prior to total knee replacement(TKR), total hip replacement(THR), or shoulder surgery in an effort to thereby reduce the incidence of persistent post-surgical pain (PPP) and enhance physical function at 3-months post-surgery. Preemptive treatment aimed at a known predictor of PPP following total knee replacement is highly innovative and have potentially high impact for public health. Cognitive therapy is a well-tolerated modality among chronic pain patients with few if any side effects. Cognitive therapy (CT) represents an inexpensive method that could greatly reduce suffering and costly post-surgical pain management for high risk TKR patients.
Read the detailed description
Aim 1 is to determine which CT protocol is most effective in reducing Pain Catastrophizing Scale (PCS) and Coping Strategies Questionnaire Catastrophizing Subscale (CSQ-CAT) scores in high-risk TKR candidates. CT will consist of four-to-eight weekly 1-hr individual cognitive therapy sessions prior to surgery.
Aim 2 is to compare the most efficient treatment from Aim 1 with a control group to evaluate pain relief at 3 months.
- Conditions
- Catastrophization
- Being tested
- Cognitive Therapy, Routine Care
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cognitive TherapyOther
CT will be used as a preemptive treatment in an effort to minimize the effects of catastrophic thinking.
Routine CareOther
Routine Care. No Cognitive Therapy Intervention
| Study group | Role | What they receive |
|---|---|---|
| 4 weekly CT sessions - in person | Experimental | 4 weekly CT sessions; all will be 1-hr individual cognitive therapy sessions with the psychology staff (under the supervision of John Burns, PhD). Receives: Other: Cognitive Therapy |
| 8 weekly CT sessions | Experimental | 8 weekly CT sessions; 1st and 8th will be 1-hr individual cognitive therapy session with the psychology staff (under the supervision of John Burns, PhD). The intermediate CT sessions will be by telephone call or video/"Skype". Our group will purchase and setup a web camera and headphone/microphone for the subjects in the CT groups that use "Skype". The 1-hr CT protocol was adapted from Dr. Beverly E. Thorn's CT manual (Cognitive Therapy for Chronic Pain: A Step-by-Step Guide; Thorn, 2004; with the Client and Therapy Workbooks. Receives: Other: Cognitive Therapy |
| 4 weekly CT sessions - Tele-video | Experimental | 4 weekly CT sessions; 1st and 4th will be 1-hr individual cognitive therapy session with the psychology staff. The intermediate CT sessions will be by telephone call or video/"Skype". Receives: Other: Cognitive Therapy |
| Routine care | Placebo comparator | Routine care; no CT sessions Receives: Other: Routine Care |
What is being measured
The primary outcome is the main question the study is designed to answer.
(Aim 1) Pain Catastrophizing Scale (PCS)
Pain Catastrophizing Scale - Min=0, Max=52, Higher score = more catastrophizing so lower scores are preferable.
Measured: 4 or 8 weeks after start of treatment
(Aim 2) Proportion of patients with pain relief
Proportion of patients w a 3 month decrease in WOMAC pain subscale <= 4. (WOMAC Osteoarthritis Index)
Measured: 3 month
Secondary outcomes (2)
Patient Health Questionnaire (PHQ-8)
Patient Health Questionnaire (PHQ-8): The eight-item Patient Health Questionnaire depression scale (PHQ-8) is established as a valid diagnostic and severity measure for depressive disorders
Measured: 4 and 8 weeks after start of treatment
Generalized anxiety disorder (GAD-7)
Generalized anxiety disorder (GAD-7): The seven-item Generalized Anxiety Disorder Scale (GAD-7) is a practical self-report anxiety questionnaire.
Measured: 4 and 8 weeks after start of treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Jan 2013 (estimated)
- Study startJan 2013
- Primary completionAug 2020
- Study completionOct 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for CatastrophizationStudies of the same condition, open and under way.
- More trials run by Rush University Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- n=80 Subjects for Aim 1 and another n=80 Subjects for Aim 2
- Masking
- Single blind
- Who is masked
- Investigator
- Enrolment
- 160 participants (actual)
Sponsor and investigators
- Lead sponsor
- Rush University Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- Pfizer
- Responsible party
- Principal investigator, Asokumar Buvanendran, Rush University Medical Center
- Investigators
- Asokumar Buvanendran, MD, Principal investigator, Rush UMC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01772329
- Sponsor's protocol ID
- 12031901
- Acronym
- CT_TKA
- Status last verified
- Jun 2022
- First submitted
- 17 Jan 2013
- Last updated
- 28 Jun 2022
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No: No plan to share data as of yet but may be willing to.
Publications
Buvanendran A, Sremac AC, Merriman PA, Della Valle CJ, Burns JW, McCarthy RJ. Preoperative cognitive-behavioral therapy for reducing pain catastrophizing and improving pain outcomes after total knee replacement: a randomized clinical trial. Reg Anesth Pain Med. 2021 Apr;46(4):313-321. doi: 10.1136/rapm-2020-102258. Epub 2021 Jan 15.
PubMed 33452201
Study at a glance
From the registry record, last updated by the sponsor on 28 Jun 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Preoperative Cognitive Therapy for Improving Health Outcomes After Total Knee Replacement in High-risk Catastrophizing Subjects
- ClinicalTrials.gov ID
- NCT01772329
- Acronym / sponsor ID
- CT_TKA / 12031901
- Conditions
- Catastrophization
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 160 participants (actual)
- Lead sponsor
- Rush University Medical CenterUniversity, hospital or other
- Collaborators
- Pfizer
- Study start
- Jan 2013 (actual)
- Primary completion
- Aug 2020 (actual)
- Study completion
- Oct 2020 (actual)
- First posted
- 21 Jan 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators propose a randomized controlled trial to evaluate the effects of treatment intended to reduce pain catastrophizing among patients reporting high pain catastrophizing prior to total knee replacement(TKR), total hip replacement(THR), or shoulder surgery in an effort to thereby reduce the incidence of persistent post-surgical pain (PPP) and enhance physical function at 3-months post-surgery. Preemptive treatment aimed at a known predictor of PPP following total knee replacement is highly innovative and have potentially high impact for public health. Cognitive therapy is a well-tolerated modality among chronic pain patients with few if any side effects. Cognitive therapy (CT) represents an inexpensive method that could greatly reduce suffering and costly post-surgical pain management for high risk TKR patients.
Detailed description
Aim 1 is to determine which CT protocol is most effective in reducing Pain Catastrophizing Scale (PCS) and Coping Strategies Questionnaire Catastrophizing Subscale (CSQ-CAT) scores in high-risk TKR candidates. CT will consist of four-to-eight weekly 1-hr individual cognitive therapy sessions prior to surgery.
Aim 2 is to compare the most efficient treatment from Aim 1 with a control group to evaluate pain relief at 3 months.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (investigator)
- Number of arms
- 4
- Model description
- n=80 Subjects for Aim 1 and another n=80 Subjects for Aim 2
| Arm | Type | Receives |
|---|---|---|
| 4 weekly CT sessions - in person | Experimental | Other: Cognitive Therapy4 weekly CT sessions; all will be 1-hr individual cognitive therapy sessions with the psychology staff (under the supervision of John Burns, PhD). |
| 8 weekly CT sessions | Experimental | Other: Cognitive Therapy8 weekly CT sessions; 1st and 8th will be 1-hr individual cognitive therapy session with the psychology staff (under the supervision of John Burns, PhD). The intermediate CT sessions will be by telephone call or video/"Skype". Our group will purchase and setup a web camera and headphone/microphone for the subjects in the CT groups that use "Skype". The 1-hr CT protocol was adapted from Dr. Beverly E. Thorn's CT manual (Cognitive Therapy for Chronic Pain: A Step-by-Step Guide; Thorn, 2004; with the Client and Therapy Workbooks. |
| 4 weekly CT sessions - Tele-video | Experimental | Other: Cognitive Therapy4 weekly CT sessions; 1st and 4th will be 1-hr individual cognitive therapy session with the psychology staff. The intermediate CT sessions will be by telephone call or video/"Skype". |
| Routine care | Placebo comparator | Other: Routine CareRoutine care; no CT sessions |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- undergoing standard primary TKR; THR or Shoulder Surgery
- 18- 85 yrs of age;
- Surgical joint is the primary source of patient's pain;
- Patient agrees to preoperative visits and treatment, follow-up visits and treatment, and to comply with the assessment tests;
- Patient consents to standard anesthetic and analgesic protocol, with medical care as deemed necessary by the anesthesiologist, and has no contraindications.
Key exclusion criteria (6 listed)
- Currently using antidepressant medication or undergoing cognitive therapy;
- chronic opioid use ≥ 10 mg/day of morphine equivalents within one wk prior to the surgery, and duration of use > 4 wks;
- history of opioid abuse;
- inability to understand and communicate with the investigators to complete the study related questionnaires
- patient is planning to undergo another elective joint procedure during the 6-mo period of participation;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cognitive TherapyCT will be used as a preemptive treatment in an effort to minimize the effects of catastrophic thinking. | Other | 4 weekly CT sessions - Tele-video, 4 weekly CT sessions - in person, 8 weekly CT sessions |
| Routine CareRoutine Care. No Cognitive Therapy Intervention | Other | Routine care |
Primary outcome
(Aim 1) Pain Catastrophizing Scale (PCS)
Time frame: 4 or 8 weeks after start of treatment
Pain Catastrophizing Scale - Min=0, Max=52, Higher score = more catastrophizing so lower scores are preferable.
(Aim 2) Proportion of patients with pain relief
Time frame: 3 month
Proportion of patients w a 3 month decrease in WOMAC pain subscale <= 4. (WOMAC Osteoarthritis Index)
2 secondary outcomes
Patient Health Questionnaire (PHQ-8)
Time frame: 4 and 8 weeks after start of treatment
Generalized anxiety disorder (GAD-7)
Time frame: 4 and 8 weeks after start of treatment
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jun 2022.
- Derived from this study: PubMed 33452201Buvanendran A, Sremac AC, Merriman PA, Della Valle CJ, Burns JW, McCarthy RJ. Preoperative cognitive-behavioral therapy for reducing pain catastrophizing and improving pain outcomes after total knee replacement: a randomized clinical trial. Reg Anesth Pain Med. 2021 Apr;46(4):313-321. doi: 10.1136/rapm-2020-102258. Epub 2021 Jan 15.
- Individual participant dataSharing planned: No. No plan to share data as of yet but may be willing to.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Asokumar Buvanendran, MD principal investigator
Rush UMC
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Cognitive Therapy and Routine Care in people with Catastrophization, run by Rush University Medical Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Jun 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
(Aim 1) Pain Catastrophizing Scale (PCS) (time frame: 4 or 8 weeks after start of treatment). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01772329, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2022.