Review
Internet interventions for chronic pain including headache: A systematic review

https://doi.org/10.1016/j.invent.2015.12.001Get rights and content
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Highlights

  • Chronic pain is a depleting health problem, however the availability of effective treatments are scarce.

  • Internet based interventions have the potential to overcome several practical barriers

  • The results of this systematic review are in line with previous reviews with small to moderate overall effects.

  • The present review has a broader inclusion of studies with studies on headache and children/youth.

  • Meta-analytic statistics were calculated for disability/interference, catastrophizing, pain intensity and mood variables.

Abstract

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.

Keywords

Chronic pain
Internet
Cognitive behavioral therapy
Headache
Pediatric pain
Self-help

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