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Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain
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Carnes, Dawn, Homer, Kate E., Miles, Clare L., Pincus, Tamar, Underwood, Martin, Rahman, Anisur and Taylor, Stephanie J.C. (2012) Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain. The Clinical Journal of Pain, 28 (4). pp. 344-354. doi:10.1097/AJP.0b013e31822ed2f3
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Official URL: http://dx.doi.org/10.1097/AJP.0b013e31822ed2f3
Abstract
OBJECTIVES: The objective of the study was to report the evidence for effectiveness of different self-management course characteristics and components for chronic musculoskeletal pain. METHODS: We searched 9 relevant electronic databases for randomized, controlled trials (RCTs). Two reviewers selected studies against inclusion criteria and assessed their quality. We classified RCTs according to type of course delivery (group, individual, mixed or remote), tutor (healthcare professional, lay or mixed), setting (medical, community or occupational), duration (more or less than 8 weeks), and the number and type of components (psychological, lifestyle, pain education, mind body therapies, and physical activity). We extracted data on pain intensity, physical function, self-efficacy, global health, and depression and compared these outcomes for self-management and usual care or waiting list control. We used random effects standardized mean difference meta-analysis. We looked for patterns of clinically important and statistically significant beneficial effects for courses with different delivery characteristics and the presence or absence of components across outcomes over 3 follow-up intervals. RESULTS: We included 46 RCTs (N=8539). Group-delivered courses that had healthcare professional input showed more beneficial effects. Longer courses did not necessarily give better outcomes. There was mixed evidence of effectiveness for components of courses, but data for courses with a psychological component showed slightly more consistent beneficial effects over each follow-up period. DISCUSSION: Serious consideration should be given to the development of short (<8 weeks) group and healthcare professional-delivered interventions but more research is required to establish the most effective and cost-effective course components. © 2012 Lippincott Williams & Wilkins, Inc.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > R Medicine (General) | ||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | The Clinical Journal of Pain | ||||
| Publisher: | Lippincott Williams & Wilkins | ||||
| ISSN: | 0749-8047 | ||||
| Official Date: | 1 May 2012 | ||||
| Dates: |
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| Volume: | 28 | ||||
| Number: | 4 | ||||
| Page Range: | pp. 344-354 | ||||
| DOI: | 10.1097/AJP.0b013e31822ed2f3 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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