{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T13:32:40Z","timestamp":1793799160781,"version":"4.6.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The primary aim of this study (<jats:italic>n<\/jats:italic>\u2009=\u2009232) 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 <jats:italic>in<\/jats:italic>flexibility predicted these long-term pain-related and health economic outcomes. We also examined psychological <jats:italic>in<\/jats:italic>flexibility as a potential mediator of these outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Small and moderate sized improvements in pain, pain interference, and depression observed at post-treatment were mostly maintained at both the 1- and 3-year follow-up. A very similar pattern was observed for health economic outcomes, with 1-year follow-up gains being maintained at long-term follow-up. Baseline psychological <jats:italic>in<\/jats:italic>flexibility predicted long-term pain-related outcomes, but not health economic outcomes. Changes in psychological <jats:italic>in<\/jats:italic>flexibility during treatment and follow-up mediated long-term pain-related outcomes and the total number of health care visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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 <jats:italic>in<\/jats:italic>flexibility 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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2025.1547540","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T06:09:07Z","timestamp":1745820547000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Long-term pain and health economic outcomes in adults receiving multidisciplinary CBT for chronic pain: the role of psychological inflexibility"],"prefix":"10.3389","volume":"6","author":[{"given":"Sophia","family":"\u00c5kerblom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance M.","family":"McCracken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Rivano Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Perrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.ejpain.2005.06.009","article-title":"Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment","volume":"10","author":"Breivik","year":"2006","journal-title":"Eur J Pain"},{"key":"B2","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.ejpain.2011.07.006","article-title":"Socio-economic burden of patients with a diagnosis related to chronic pain\u2013register data of 840,000 Swedish patients","volume":"16","author":"Gustavsson","year":"2012","journal-title":"Eur J Pain"},{"key":"B3","doi-asserted-by":"publisher","first-page":"Cd007407","DOI":"10.1002\/14651858.CD007407.pub4","article-title":"Psychological therapies for the management of chronic pain (excluding headache) in adults","volume":"8","author":"Williams","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1037\/0278-6133.26.1.1","article-title":"Meta-analysis of psychological interventions for chronic low back pain","volume":"26","author":"Hoffman","year":"2007","journal-title":"Health Psychol"},{"key":"B5","volume-title":"Rehabilitering vid l\u00e5ngvarig sm\u00e4rta. 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