JAMA

Telehealth and online CBT improved outcomes in chronic pain

July 28, 2025

Remote, scalable cognitive behavioral therapy for chronic pain (CBT-CP) interventions offer modest but meaningful improvements in pain and function, with potential to expand access to evidence-based, nonpharmacologic pain management—particularly in rural and underserved populations.

Study details. The Tailored Non-Pharmacotherapy Services for Chronic Pain (RESOLVE) phase 3 randomized trial (NCT04523714) evaluated the effectiveness of two remote CBT-CP interventions—telehealth (health coach-led) and online self-guided (painTRAINER)—compared with usual care. A total of 2,331 adults with high-impact chronic musculoskeletal pain were enrolled from four U.S. health systems between January 2021 and February 2023, with follow-up through April 2024.

Results. At 3 months, 32% of participants in the health coach group and 27% in the painTRAINER group achieved ≥30% reduction in pain severity, compared with 21% in the usual care group. Both interventions significantly outperformed usual care (relative risk [RR], 1.54 and 1.28, respectively), with the health coach model also outperforming painTRAINER (RR, 1.20). Benefits persisted at 6 and 12 months across pain and functional outcomes.

Source:

DeBar LL, et al. (2025, July 23). JAMA. Telehealth and Online Cognitive Behavioral Therapy-Based Treatments for High-Impact Chronic Pain: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40699570/