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Online pain management programs for chronic, widespread musculoskeletal conditions : A systematic review with meta-analysis
Chew, Min Tze Chan, Cliffton Kobayashi, Sarah Cheng, Hoi Yan Wong, Tsz Ming Nicholson, Leslie L.
Chew, Min Tze
Chan, Cliffton
Kobayashi, Sarah
Cheng, Hoi Yan
Wong, Tsz Ming
Nicholson, Leslie L.
Abstract
Face-to-face pain management programs demonstrate positive clinical outcomes in the chronic pain population by improving pain intensity and attitudes, depression, and functional disability scores. The effects of this modality carried out online is less known, particularly in subgroups of chronic pain. This systematic review assessed the effects of online pain management programs in chronic, widespread musculoskeletal conditions on pain measurements (intensity, interference, coping, and catastrophizing), health-related quality of life, depression, and anxiety scores immediately post-intervention. Five electronic databases (Embase, Medline, CINAHL, Scopus, and PEDro) were searched with 3546 studies identified. Eighteen randomized controlled trials fulfilled the inclusion criteria. Included studies had moderate methodological quality (using the Effective Public Health Practice Project (EPHPP) quality assessment tool) but high risk of bias (using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2)). There were significant improvements in pain intensity (11 studies, 1397 participants, SMD −0.30, 95% CI −0.50 to −0.10, p = 0.004), health-related quality of life (eight studies, 1054 participants, SMD 0.41, 95% CI 0.08 to 0.75, p = 0.02), and depression (nine studies, 1283 participants, SMD −0.32, 95% CI −0.55 to −0.08, p = 0.008). However, effect sizes were small and did not meet their respective measure's minimal clinically important change score. Guided interventions (regular interaction with an instructor) appeared to be superior to self-completed interventions. Future research should standardize outcome measures for assessing pain, use active control groups, and analyze other outcome measures such as cost and long-term effects. This study was registered with Prospero on August 15, 2021 (CRD42021267565).
Keywords
arthritis, fibromyalgia, musculoskeletal diseases, pain, telehealth
Date
2023
Type
Journal article
Journal
Pain Practice
Book
Volume
23
Issue
6
Page Range
664-683
Article Number
ACU Department
Non-faculty
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC 4.0
File Access
Open
Notes
© 2023 The Authors. Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.