CHRONIC PAIN

Could Chronic Pain Patients Benefit from Psychological Interventions?

May 10, 2018

Psychological interventions, especially in group settings, may be beneficial for older adults with chronic pain, according to a recent systematic review and meta-analysis.

For their review, the researchers evaluated 22 studies (n = 2608). All studies included in the present analysis had assessed the effects of psychological interventions that used cognitive behavioral modalities alone or in combination with another strategy among individuals aged 60 years and older with chronic pain for at least 3 months.
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Study data from inception to March 29, 2017 were obtained from MEDLINE, Embase, PsycINFO, and the Cochrane Library databases.

The researchers found that that differences of standardized mean differences (dD) at post-treatment were pain intensity (dD = -0.181), pain interference (dD = -0.133), depressive symptoms (dD = -0.128), anxiety (dD = -0.205), catastrophizing beliefs (dD = -0.184), self-efficacy (dD = 0.193), physical function (dD = 0.006), and physical health (dD = 0.160).

Ultimately, results indicated that only pain demonstrated evidence of effects that persisted beyond the post-treatment assessment (dD = -0.251). Furthermore, findings from moderator analyses showed that only mode of therapy demonstrated a consistent effect in favor of group-based therapy vs individual therapy.

“Psychological interventions for the treatment of chronic pain in older adults have small benefits, including reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain,” the researchers concluded. “These results were strongest when delivered using group-based approaches.”

“Research is needed to develop and test strategies that enhance the efficacy of psychological approaches and sustainability of treatment effects among older adults with chronic pain,” they added.

—Christina Vogt

Reference:

Niknejad B, Bolier R, Henderson CR, et al. Association between psychological interventions and chronic pain outcomes in older adults: a systematic review and meta-analysis [Published online May 7, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.0756