Internet interventions for chronic pain including headache: A systematic review

Chronic pain is a major health problem and behavioral based treatments have been shown to be effective. However, the availability of these kinds of treatments is scarce and internet-based treatments have been shown to be promising in this area. The objective of the present systematic review is to ev...

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Main Authors: Monica Buhrman, Torsten Gordh, Gerhard Andersson
Format: Article
Language:English
Published: Elsevier 2016-05-01
Series:Internet Interventions
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214782915000421
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author Monica Buhrman
Torsten Gordh
Gerhard Andersson
author_facet Monica Buhrman
Torsten Gordh
Gerhard Andersson
author_sort Monica Buhrman
collection DOAJ
description Chronic pain is a major health problem and behavioral based treatments have been shown to be effective. However, the availability of these kinds of treatments is scarce and internet-based treatments have been shown to be promising in this area. The objective of the present systematic review is to evaluate internet-based interventions for persons with chronic pain. The specific aims are to do an updated review with a broad inclusion of different chronic pain diagnoses and to assess disability and pain and also measures of catastrophizing, depression and anxiety. A systematic search identified 891 studies and 22 trials were selected as eligible for review. Two of the selected trials included children/youth and five included individuals with chronic headache and/or migraine. The most frequently measured domain reflected in the primary outcomes was interference/disability, followed by catastrophizing. Result across the studies showed a number of beneficial effects. Twelve trials reported significant effects on disability/interference outcomes and pain intensity. Positive effects were also found on psychological variable such as catastrophizing, depression and anxiety. Several studies (n = 12) were assessed to have an unclear level of risk bias. The attrition levels ranged from 4% to 54% where the headache trials had the highest drop-out levels. However, findings suggest that internet-based treatments based on cognitive behavioural therapy (CBT) are efficacious measured with different outcome variables. Results are in line with trials in clinical settings. Meta-analytic statistics were calculated for interference/disability, pain intensity, catastrophizing and mood ratings. Results showed that the effect size for interference/disability was Hedge's g = −0.39, for pain intensity Hedge's g = −0.33, for catastrophizing Hedge's g = −0.49 and for mood variables (depression) Hedge's g = −0.26.
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spelling doaj.art-c707b4d268784e8d953fa6e7c33765fc2022-12-22T03:44:10ZengElsevierInternet Interventions2214-78292016-05-014P1173410.1016/j.invent.2015.12.001Internet interventions for chronic pain including headache: A systematic reviewMonica Buhrman0Torsten Gordh1Gerhard Andersson2Department of Psychology, Uppsala University, Uppsala, SwedenDepartment of Surgical Sciences, Pain Research, Uppsala University, Sweden.Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, SE-581 83 Linköping, SwedenChronic pain is a major health problem and behavioral based treatments have been shown to be effective. However, the availability of these kinds of treatments is scarce and internet-based treatments have been shown to be promising in this area. The objective of the present systematic review is to evaluate internet-based interventions for persons with chronic pain. The specific aims are to do an updated review with a broad inclusion of different chronic pain diagnoses and to assess disability and pain and also measures of catastrophizing, depression and anxiety. A systematic search identified 891 studies and 22 trials were selected as eligible for review. Two of the selected trials included children/youth and five included individuals with chronic headache and/or migraine. The most frequently measured domain reflected in the primary outcomes was interference/disability, followed by catastrophizing. Result across the studies showed a number of beneficial effects. Twelve trials reported significant effects on disability/interference outcomes and pain intensity. Positive effects were also found on psychological variable such as catastrophizing, depression and anxiety. Several studies (n = 12) were assessed to have an unclear level of risk bias. The attrition levels ranged from 4% to 54% where the headache trials had the highest drop-out levels. However, findings suggest that internet-based treatments based on cognitive behavioural therapy (CBT) are efficacious measured with different outcome variables. Results are in line with trials in clinical settings. Meta-analytic statistics were calculated for interference/disability, pain intensity, catastrophizing and mood ratings. Results showed that the effect size for interference/disability was Hedge's g = −0.39, for pain intensity Hedge's g = −0.33, for catastrophizing Hedge's g = −0.49 and for mood variables (depression) Hedge's g = −0.26.http://www.sciencedirect.com/science/article/pii/S2214782915000421Chronic painInternetCognitive behavioral therapyHeadachePediatric painSelf-help
spellingShingle Monica Buhrman
Torsten Gordh
Gerhard Andersson
Internet interventions for chronic pain including headache: A systematic review
Internet Interventions
Chronic pain
Internet
Cognitive behavioral therapy
Headache
Pediatric pain
Self-help
title Internet interventions for chronic pain including headache: A systematic review
title_full Internet interventions for chronic pain including headache: A systematic review
title_fullStr Internet interventions for chronic pain including headache: A systematic review
title_full_unstemmed Internet interventions for chronic pain including headache: A systematic review
title_short Internet interventions for chronic pain including headache: A systematic review
title_sort internet interventions for chronic pain including headache a systematic review
topic Chronic pain
Internet
Cognitive behavioral therapy
Headache
Pediatric pain
Self-help
url http://www.sciencedirect.com/science/article/pii/S2214782915000421
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