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The effectiveness of cognitive behavioral based online interventions for chronic pain: a systematic review and meta-analysis

Sieveneck, Sven (2019) The effectiveness of cognitive behavioral based online interventions for chronic pain: a systematic review and meta-analysis.

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Abstract:Chronic pain is a condition with high prevalence (12%-30%) that has a big impact on the daily functioning of those affected. Chronic pain patients have problem with sleeping, walking and other daily activities and often suffer from comorbid depression. Furthermore, it has a big impact on the economy. Cognitive behavioral therapy is an effective treatment, but patients have to wait long times before they can start therapy, and it is time and cost intensive. These problems could be solved by cognitive behavioral online interventions. Therefore, the objective of this review was to examine the effectivity of online-based cognitive-behavioral treatments for chronic pain. Systematic searches of the databases Scopus, PsychINFO, Pubmed and the Cochrane Database for Clinical trials were conducted. Eligibility criteria were that the studies had to be randomized controlled trials, online-cognitive-behavioral interventions, a sample size of N³ 20 per study arm, published between 2005 and 2018 and that the patients in the studies were suffering from pain longer than 3 months. The decision was made to examine the effectiveness of cognitive behavioral online interventions on pain intensity, disability, depression, pain catastrophizing and quality of life. Finally, 18 studies were included with a total of 2711 participants (76% female). The mean age differed across the studies from 14.3 to 63.37 years of age. The results of the metaanalysis revealed small but significant between-group effects on pain intensity (-. 28(-0.37, - 0.19)), pain related disability (-.29(-0.38, -0.21)), depression (-.33(-0.41, -0,24)) and pain catastrophizing (-.44(-0.55, - 0.32)) in favor of the online CBT-treatments compared with the control conditions. For quality of life, the between-group effect was moderate (.65(0.45, 0.85)). Subgroup analysis showed that the between-group effect was the highest when comparing online CBT-treatment to a waiting-list control group (moderate). Only for pain catastrophizing, the between-group effect was the highest compared to other active treatment control groups. The results of this review provide evidence, that online-CBT can be implemented to treat chronic pain and related symptoms effectively, with treatment effects comparable to the effectivity found in review about face-to-face CBT. Online CBT-interventions can develop the greatest benefit when it is implemented across patients on waiting lists. Thus, online-CBT should be included in primary mental health care for chronic pain.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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