Maintaining musculoskeletal health using a behavioural therapy approach: a population-based randomised controlled trial (the MAmMOTH Study)

Objective Cognitive–behavioural therapy (CBT) has been shown to be effective in the management of chronic widespread pain (CWP); we now test whether it can prevent onset among adults at high risk. Methods A population-based randomised controlled prevention trial, with recruitment through UK general practices. mailed screening questionnaire identified risk CWP. Participants received either usual care (UC) or a short course telephone CBT (tCBT). The primary outcome was CWP 12 months assessed by questionnaire. There were seven secondary outcomes including quality life (EuroQol Questionnaire-five dimensions-five levels/EQ-5D-5L) used as part health economic assessment. Results 996 participants and included intention-to-treat analysis which 825 provided data. median age 59 years; 59% women. At there no difference (tCBT: 18.0% vs UC: 17.5%; OR 1.05; 95% CI 0.75 1.48). who tCBT more likely report better (EQ-5D-5L utility score mean 0.024 (95% 0.009 0.040)); had 0.023 0.007 0.039) quality-adjusted life-years an additional cost £42.30 ?£451.19 £597.90), yielding incremental cost-effectiveness ratio £1828. Most showed significant benefit for intervention. Conclusions did not risk, but improved cost-effective. low-cost, short-duration intervention benefits persons Trial registration number ClinicalTrials.gov Registry ( NCT02668003 ).