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Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: a systematic literature review

Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: a systematic literature review
Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: a systematic literature review
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
0749-8047
344-354
Carnes, Dawn
bd9800b7-b0aa-46f0-b7f0-bcff5f8f0326
Homer, Kate E.
7cc8c356-cf8e-4a03-b51c-d357cc284012
Miles, Clare L.
2c3cd0e5-1aaf-46b6-8228-188c843bad4e
Pincus, Tamar
23ede007-6485-4b08-93df-077af02f30b4
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Rahman, Anisur
cb88abd6-00b3-44da-87bf-a7772844dc86
Taylor, Stephanie J.C.
62fdb6bf-40a7-4e4b-b705-a96e71dbebbe
Carnes, Dawn
bd9800b7-b0aa-46f0-b7f0-bcff5f8f0326
Homer, Kate E.
7cc8c356-cf8e-4a03-b51c-d357cc284012
Miles, Clare L.
2c3cd0e5-1aaf-46b6-8228-188c843bad4e
Pincus, Tamar
23ede007-6485-4b08-93df-077af02f30b4
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Rahman, Anisur
cb88abd6-00b3-44da-87bf-a7772844dc86
Taylor, Stephanie J.C.
62fdb6bf-40a7-4e4b-b705-a96e71dbebbe

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: a systematic literature review. The Clinical Journal of Pain, 28 (4), 344-354. (doi:10.1097/Ajp.0b013e31822ed2f3). (PMID:22001667)

Record type: Article

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

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Published date: May 2012
Organisations: Psychology

Identifiers

Local EPrints ID: 355329
URI: https://eprints.soton.ac.uk/id/eprint/355329
ISSN: 0749-8047
PURE UUID: 33032bfb-bcd7-45fa-be27-8eb988746105

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Date deposited: 15 Aug 2013 14:03
Last modified: 16 Jul 2019 21:26

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Contributors

Author: Dawn Carnes
Author: Kate E. Homer
Author: Clare L. Miles
Author: Tamar Pincus
Author: Martin Underwood
Author: Anisur Rahman
Author: Stephanie J.C. Taylor

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